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

Hanna Kienzler is Professor of Anthropology and Global Health at the Department of Global Health and Social Medicine and co-director of the ESRC Centre for Society and Mental Health at King’s College London. She investigates how systemic violence, ethnic conflict and complex emergencies intersect with health and mental health outcomes in the occupied Palestinian territory, Kosovo, and, among refugees, in the UK.

What is your article “SymptomSpeak: Women’s Struggle for History and Health in Kosovo” about?

My article contributes to a new understanding of pain as a shareable language. Fundamentally, I ask: Can we feel the pain of others? How does pain connect and reach across histories, gendered realities, and social politics? How is illness shaped by context, and what kind of life worlds rise from it? I explore these questions among women in Kosovo who use a unique symptomatic language to communicate their pain and suffering about the Kosovo War and post-war hardships. I call this language SymptomSpeak. SymptomSpeak consists of a detailed symptom vocabulary which women variously assemble to exchange concerns about their country’s recent violent past; current local, national, and international political and economic agendas; and dominant power hierarchies. Such exchanges are hard physical and emotional labour. They are exhausting as the language of pain intensifies and, thereby, materializes not only in the speaker’s body, but in the bodies of the listeners. In the article I show that pain straddles a fine line between socio-political commentary and illness; produces gendered political realities; and challenges the status quo through its communicative power.

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

I completed my PhD in cultural and medical anthropology in the Departments of Anthropology and Social Studies of Medicine at McGill University in Montreal. My dissertation explored the impact of war and violence on women survivors of the Kosovo War. Conducting ethnographic research, I lived with a war widow and her children in Krusha e Made and observed and listened to women’s painful expressions as they unfolded in the everyday and were reflected upon by different groups of people including the women themselves, but also by other villagers, aid providers, and health professionals including traditional healers.

Later, I worked as a Postdoctoral Fellow in the Department of Psychiatry and the Psychosocial Research Division at the Douglas Mental Health University Institute at McGill University. This is when I began to conduct research on humanitarian and mental health interventions in fragile states with a particular focus on Kosovo and Palestine, and started a project to explore expressions of distress among torture survivors in Nepal. In 2012, I became Assistant Professor in the newly founded Department of Global Health and Social Medicine at King’s College London. I had the privilege to help build an entirely new department with colleagues from different parts of the world. I also built my own interdisciplinary research programme in the field of war and mental health.

In Palestine, I explore what it means for persons with severe mental illness to live and participate in their communities; wellbeing and access to education among young people with disabilities living in refugee camps; and the association between uncertainty and mental health. In the UK, I co-founded the Refugee Mental Health and Place network to better understand how the hostile environment affects mental health and wellbeing of refugees, asylum seekers and undocumented migrants. I also strengthen research capacity of mental health providers and researchers in the MENA region to contribute to efforts of building a locally driven and locally relevant evidence base.

On top of this, I am co-director of the ESRC Centre for Society and Mental Health where I work with inspiring colleagues to shift public debate about mental health away from a focus on individualised interventions, towards social practices and policies that promote and sustain good mental health in communities.

What drew you to this project?

There is a long story and a short story. The short story is that I had undertaken an internship with the International Committee of the Red Cross in Kosovo in 2004. I shadowed newly trained community mental health workers in the Peja region learning about the horrors of the Kosovo War, their impact on people’s lives and the long-term mental health consequences of violence and deprivation. I wanted to know more about how women expressed their distress in culturally resonant ways and how this led to particular help and health-seeking and evaluation of treatment. This then led me to do my PhD under the supervision of Professor Alan Young and Dr Duncan Pedersen and a long-term engagement with life in Kosovo that lasts until this day. The more personal story is less straightforward and career driven.

As part of my Master’s dissertation, I carried out ethnographic research among Hutterites in the US and Canada. Living on Hutterite colonies for over 6 months, I learned about historical trauma and its effects on community life, community longevity, and identity. This interested me considering that my own family carries a complex history of war and refuge, of perpetrating violence and losing everything. Growing up there was a lot of silence around certain issues and a demand to speak up in the face of injustice. Trying to make sense of these seeming contradictions and complexities was confusing and not easy. To this day, I am learning, slowly and carefully. Most of us who research war, trauma, and mental health don’t come to it from a purely scientific angle. There is always a personal story

What was one of the most interesting findings?

One of my most interesting and maybe important findings was that pain is not unspeakable. Pain itself is a means of communication that brings, in combination with other forms of articulation, complex truths to the fore. It incites memories and enables us to exchange stories. As part of my research, I began compiling lists of symptoms as they arose in conversations, situations and social interactions among women who had survived the Kosovo War. I jotted the symptoms down in notebooks and on scraps of papers before ordering them. The developing “inventory” was obviously fragmented, but it permitted me to shift my attention to the creative interpretation and use of symptoms as something else. Symptoms, I learned were connected to the status of widowhood, which was often experienced as oppressive leading to feelings of nervousness, worry, sadness and pain.

Yet, social and economic insecurities and family conflicts could be just as triggering for symptoms to surface. With time, I became to realize that symptoms were a communicative vehicle through which women connected inner and outer worlds and were able to make claims upon their listeners for recognition of their past and present hardship. It was through such symptomatic exchanges that new framings of the past and novel ways for engaging in the present moment could be created with the power to reveal both uncomfortable truths concerning social inequities, lack of communal support and failing political commitment and imaginaries for a better future filled with possibilities and prosperity. Accordingly, the women’s symptom lexicon was not just about personal trauma and hardship, but a vehicle through which to make visible what needs changing on familial, communal and political levels so as to rebuild their country in the aftermath of war.

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

I always have a novel on the go. Right now, I am reading In the Ditch by Buchi Emecheta. It’s a semi-autobiographical account of a young Nigerian woman living with her children in the slums of North London sometime in the mid-1960s. It’s beautifully written. I just finished watching “Once upon a time in Iraq” on BBC iPlayer – the series shook me, so I am still processing. I am listening to Wheel of Misfortune – it’s very funny and makes me laugh..

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

Action points sounds maybe a bit too technical for my work related to SymptomSpeak. But I wish we paid more attention to the pain of others by giving it, to use Veena Das’ words, a home in our bodies. Thereby, we might be able to hear more clearly and, yes painfully, what people have to tell us and start acting to make the world a better, less painful place. In my article, I write that Barbara Prainsack suggested to me in a personal conversation to think of such exchanges as an act of “conspirare”. I love this idea – conspirare means ‘‘breathing together’’ and is also the foundation of the word to ‘‘conspire,’’ that is, the act of collusion between people who secretly plan to do something against someone else’s wishes. I don’t think that we will change the world for the better by acting according to the wishes of those in power. Rather, we need to conspire to question, complicate, destabilize, and eventually topple the status quo and its dominant versions of history, social structures, and power dynamics.

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Other places to connect:
Website
Twitter
Mastodon
Symptom Speak on Twitter and Facebook
ESRC Centre for Society and Mental Health
Refugee Mental Health and Place Network
Get to know us! Our lives with mental illness in the Palestinian community: www.get-to-know-us.com