Interview With Dr. Fahimeh Mianji

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

Fahimeh Mianji (Ph.D., R Psych) is a transcultural clinical psychologist and global mental health researcher in the Division of Social and transcultural Psychiatry, McGill University. Dr. Mianji’s research is on globalization of American psychiatric diagnoses and treatments; sociocultural, structural, and political determinants of mental illness; and access and barriers to mental health services for refugees and immigrant populations. As a clinical psychologist, she currently works with minoritized populations in Quebec and British Colombia.

What is your article “Women as Troublemakers”: The Hard Sociopolitical Context of Soft Bipolar Disorder in Iran” about?

Despite the promising trend of women’s health in Iran over the past four decades, there is still a significant difference between women and men with respect to mental, physical, and social health. Among women’s burden of disease, psychological disorders ranked first in this country. We used multi-sited focused ethnography and archive analysis to explore the sociocultural and political dynamics of the over-use of bipolar spectrum disorder (BSD) diagnosis among women in Iran. The dominant biological psychiatry system in Iran has led many psychiatrists to frame sociopolitically and culturally rooted forms of distress in terms of biomedical categories like soft bipolarity and to limit their interventions to medication. This bioreductionist approach silences the voices of vulnerable groups, including those of women, and marginalizes discussions of problematic institutional and social power. To understand the preference for biomedical explanations, we need to consider not only the economic interests at play in the remaking of human identity in terms of biological being and the globalization of biological psychiatry, but also the resistance to addressing the sociocultural, political, and economic determinants of women’s mental suffering in particular contexts.

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

I am a clinical psychologist and global mental health researcher. My clinical work is influenced by my training in transcultural psychiatry at McGill university where ecosocial, anti-oppressive, and community-based perspectives to individual’s mental wellbeing are promoted in both research and clinical domains. My published works focus on the vicissitudes of Bipolar Spectrum Disorder diagnosis and treatment in Iran, medicalization of women’s social and political conflicts in Iran, and cultural and linguistic barriers to access mental health services among refugees and immigrants in Quebec.

What drew you to this project?

When I was a psychology graduate student from 2006 to 2008, I noticed that my psychiatry and psychology professors and colleagues spoke passionately about finding features of “bipolarity” in their patients. And, over the subsequent few years, this diagnosis has become so common that a group of psychiatrists who disagreed with the dramatic increase in bipolar diagnosis started calling their colleagues, “bipolar-minded” psychiatrists. The term “bipolar-minded psychiatrist”—that is, a psychiatrist who looks at everyone through bipolar glasses—has become a popular professional label in Iran. It was at about the same time that I noticed a related jargon of “bipolarity” was being used by friends and families as well. But in this case, it was more than just talking about their bipolarity as a metaphor for emotional ups and downs; it was lay people, mostly women, talking about taking mood stabilizers and antipsychotic medication as easily as taking acetaminophen for the common cold! It appeared the professional embrace of bipolarity was penetrating far into society to affect everyday discourse about emotional distress and the ways that people handled such problems. So, in a way, my first idea for this study came from my experience as trainee in psychology and an observer of the ongoing emergence of new psychiatric disorders. Since then, I have developed a broader interest in the anthropology of psychiatry and in the cultural analysis and critique of the institutions and practices of psychiatry itself.

What was one of the most interesting findings?

To me, understanding how psychiatric institutions can collude with the political and ideological agendas in oppressing voices (particularly youth’s and women’s) that confront the sociocultural and structural factors involved in the violation of individual’s rights and freedom was an interesting finding of this study.

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

In the past two months, I have spent most of my spare time on reading and watching how young women and youth in Iran are using their great energy of injustice anger to break down the walls of a patriarchal and oppressive state; and how these people enact their agency through repositioning their bodies in a society where the state has practiced his power through controlling women’s bodies for over four decades. The videos and stories of the current feminist revolution in Iran as well as people’s resistance and hope are great means for reorienting my research and clinical knowledge, my values, and my first-hand experiences as a woman who had to work hard to protect her beliefs over “knowing what she knows” in the context of a patriarchal and oppressive political, social, and cultural climate in Iran.

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

As mental health clinicians and researchers, we must not forget that our responsibility is to be invested in truth and to protect our patients from the social, cultural, and structural defects instead of colluding with the rigid and oppressive institutions through normalizing and individualizing such defects which affect people’s wellbeing on different levels.

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