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

Gabriel is a Postdoctoral Research Fellow at the Center for Culture and the Mind (CULTMIND) at the University of Copenhagen, Denmark, and an Adjunct Researcher at the Research Program in History and Critical Theory of Psy Knowledge at the Diego Portales University, Chile.

He is a medical anthropologist, clinical psychologist, and psychoanalyst. He has been a lecturer and researcher at the University of Santiago, Diego Portales University, the University of Chile, King’ College London, and the University of Copenhagen. He has also been advisor of the Pan American Health Organization (PAHO/WHO) and he is a co-founder of the Platform for Social Research on Mental Health in Latin America (PLASMA).

What is your article “Structuralizing Culture: Multicultural Neoliberalism, Migration, and Mental Health in Santiago, Chile” about?

My article provides historical insights into contemporary cultural and structural competency debates. It focuses on how the arrival of Afro-descendant migrants, mainly from Haiti and the Dominican Republic, has led to the emergence of new discourses on migration, multiculturalism, and mental health in health services in Chile since 2010. Based on a multi-sited ethnography conducted over 14 months in a neighborhood of northern Santiago, I argued that health practitioners tended to redefine cultural approaches in structural terms focusing mainly on class aspects such as poverty, social stratification, and socioeconomic inequalities. I affirm that this structural-based approach finds its historical roots in a political and ideological context that provided the conditions for the development of community psychiatry experiences during the 1960s and 1970s, as well as in multicultural and gender policies promoted by the state since the 1990s.

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

I am interested in the politics and practices of psychiatry and global mental health and their impacts on subjectivity and everyday life with a special focus on Latin America. My work has focused mainly on the interactions between psy-disciplines, global mental health, and Haitian and Dominican migrants in Chile. More recently, I have also been interested in the intersections between history, psy-disciplines, and genomics and their impacts at a subjective and socio-political level.

What drew you to this project?

I was working as a clinical psychologist at a public family health center in Santiago in 2014 when I realized the various challenges practitioners faced while working with migrants. These challenges were not only related to “access” or “cultural” and “language” barriers but also to epistemic and technical issues in clinical encounters. In this context, I applied for an ANID-BecasChile PhD Scholarship and completed my PhD at the Department of Global Health and Social Medicine at King’s College London between 2016 and 2020. My research examined how new discourses and practices related to migration, multiculturalism, and mental health have emerged in neoliberal post-dictatorship Chile (1990–2019). Specifically, I explored how the introduction of health reforms and the global mental health agenda have impacted and shaped the subjectivity and everyday life of Haitian and Dominican migrants.

What was one of the most interesting findings?

The influence of the different politics and ideologies on adopting “cultural approaches” in public health during the recent history of Chile. For example, it was very stimulating to observe how practitioners, influenced by the legacies of revolutionary community psychiatry experiences in the 1960s and 1970s, redefined cultural approaches in structural terms focusing mainly on class aspects such as poverty, social stratification, and socioeconomic inequalities. Besides this, it was interesting to analyze how new discourses on multiculturalism and gender are involved in this redefinition.

What are you reading, listening to, and/or watching right now? (Doesn’t have to be anthropological!)

I am reading a book in Spanish titled “La Medicine Árabe en España” (“The Arab Medicine in Spain”) written by Fidel Fernández and published in 1936

And I am watching a TV series call “The Bear”.

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

I hope this article invites readers to reflect on the intersections between history, politics, ideologies, and health systems in their own contexts. I believe that this is particularly relevant as a first step before adopting cultural or structural competency models or any other related model.

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Academia profile

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

I’m a sociologist specializing in medical and mental health sociology, exploring health, ability, and technology intersections. My research focuses on medical technology’s social impact, and I edited a volume about medical technology and society. I’m currently writing a book on digital and AI technology and psychiatric patient monitoring and surveillance

What is your article “Psych Unit Gangs: An Autoethnography” about?

People with mental illness diagnoses often face unfair treatment from society. But even among those with mental health issues, there appears to be a hierarchy and some people with mental health diagnoses stigmatize others with different diagnoses. In psychiatric hospitals, patients sometimes create rankings based on their diagnoses. As someone who has experienced psychosis, I’ve been at the bottom of this ranking. Patients with conditions like depression or addiction, which are seen as less severe, often exclude and judge those of us with psychotic disorders. This creates a power imbalance, where one group that already faces discrimination treats another group even worse. Using ideas from sociology, I look at how these groups form and how quickly patients figure out where they fit in the hospital’s social structure. To help solve this problem, we need to change how psychotic disorders are shown in popular media and culture.

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

I am a sociologist of medicine, mental health, ability, and technology, and am fascinated by the intersection of these areas. My first work in this area involved Deaf cultural identity and deaf technology such as hearing aids and cochlear implants. That project focused on the concept of normality and the use of technology to make people “normal.” That work led naturally to my current project, which involves the examination of advanced digital and AI technology and psychiatric surveillance. I am interested in how technological surveillance of those with mental health diagnoses is used to reinforce “normality,” but am also interested in the ethical, political, and social implications of these technologies, especially as they relate to patient autonomy, privacy, and impacts on the doctor-patient relationship.

What drew you to this project?

This autoethnography was borne out of my 19th hospitalization for a psychotic episode. As someone with a schizophrenia-spectrum diagnosis, I am no stranger to psychiatric hospitals and the patient rituals and social dynamics within them, but this hospitalization was different from all my others. During this hospitalization, I noticed a distinct hierarchy forming among the patients, and that was something that I had never seen before. I immediately saw the sociological implications of the social organization within the unit and was inspired to write this autoethnography about my experience. Additionally, I believe strongly in “Disclosure as Activism” and wanted to take this opportunity to blend my identity as a scholar with my identity as a person with a schizophrenia-spectrum illness.

What was one of the most interesting findings?

The most interesting finding is that these hierarchical groups remained, and the stigma from the “mood disorder group” toward the “psychotic group” remained even when there was turnover in group membership. Even when the de facto “leader” of the “mood disorder group” left the unit, and all the original members of that group had moved on, the group was re-populated with new members who continued the stigmatizing behavior.

What are you reading, listening to, and/or watching right now? (Doesn’t have to be anthropological!)

I am watching an amazing Pakistani show called “Barzakh” right now. It tackles metaphysical issues, but it is also a very interesting social experiment, because it also includes gay characters, animal cruelty, nudity, and cursing- all things that are usually not included in Pakistani productions. The show was streamed for free on YouTube, but due to death threats from Pakistani viewers toward the Pakistani actors and directors, it was recently pulled from Pakistani YouTube. It is still available to the rest of the world to watch, though, and I highly recommend it. Beyond the great story and interesting questions that it raises about death and life, it is set in the magnificent Hunza Valley, which I will never get bored of seeing.

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

Actually, one of the most important parts of the piece is not in the content as much as it is in the context of the work- I am a prolific scholar and professor who also has a schizophrenia spectrum diagnosis. These two facts about me should not be considered incompatible or startling. I hope that one of the results of the publication of this paper is that because academics experience psychiatric diagnoses just as much as other people, we should start talking about it, and de-stigmatize it within the academy. 

Other places to connect:
Website

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

Mrs. Rodrigues-Müller is a psychiatrist, Collective Health PhD, and a professor of Mental Health at the
undergraduate medical school at the State University of Rio
de Janeiro (UERJ) Medical School (Medical Sciences School).

What is your article “Mental Health Collaborative Care in Brazil and the Economy of Attention: Disclosing Barriers and Therapeutic Negotiations” about?

This article examines an experience of mental health collaborative care in the city of Rio de Janeiro as an
illustration of mental health interventions in local contexts. Structural and sociocultural issues affect
each region and health services differently, and health teams and healthcare managers need to identify
and integrate these variations in the planning of health interventions. We argue that it is in the everyday
interactions that the processes of incorporating different epistemologies and logics of care are
manifested.

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

I am a psychiatrist, and I have done my medical residence in public mental health program in Rio de
Janeiro in the beginning of 2000’s. I have been working in public mental health services since them. I’m
also mental health professor at UERJ. My work experience has influenced me and my interest in studying
sociocultural features setting up mental suffering.

What drew you to this project?

My interest was understanding how different perspectives on mental suffering were recognized and
dealt with among health professionals, users, families and communities.

What was one of the most interesting findings?

Brazilian public health emphasizes the social determination of health-disease processes and has
contributed significantly to the knowledge and health care developed in the country. However, an
economy of attention approach can expand our understanding of the social and cultural dimensions that
shape health phenomena. We must encourage health professionals and health systems to incorporate
the complex interweaving of material and human conditions that shape health care.

What are you reading, listening to, and/or watching right now? (Doesn’t have to be anthropological!)

I’ve just finished Silvia Federici’s book – Beyond the periphery of the skin: rethinking, remaking and
reclaiming the body in contemporary capitalism; And now I am reading Eduardo Viveiros de Castro’s
book – Cannibal metaphysics: Amerindian perspectivism.

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

It is in the everyday interactions that the processes of incorporating the different epistemologies and
logics of care are manifested. Focusing on negotiations enables appreciation of the role played by social
actors in these exchanges and other features related to access and quality care.

Other places to connect:

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

Dr. Julia Knopes is an anthropologist who studies lived experiences of mental health recovery and medical education. She has cross-disciplinary training in social science and the humanities, and teaches courses in disability studies and mental health ethics.

What is your article “Beyond Competence: Efficiency in American Biomedicine” about?

Anthropologists and sociologists have written much about the values and principles that shape contemporary medical practice. Through qualitative research at two medical schools in the U.S. Midwest, our team found that one such value is efficiency: that is, the ability to maximize productivity while minimizing wasted effort. Medical students’ narratives reveal that they choose learning resources and engage in study practices in ways that align with efficiency, ensuring that they learn only what is most needed and not squandering time or energy on information that is thought to be unnecessary to their education and future practice. We describe these findings in light of research on broader trends in U.S. biomedicine towards efficiency, such as the proliferation of the managed care model. While medical students and physicians are trained to be competent, we find that they are also socialized to be efficient.

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

I am a medical anthropologist, health humanist, and empirical bioethicist by training. The primary focus of my teaching and research is in the areas of disability and mad studies, specifically on lived experiences of recovery amongst people with mental health conditions. I have a secondary scholarly interest in medical education and practice, specifically how medical students and physicians cope with the impossibility of knowing everything there is to know about biomedicine.

What drew you to this project?

I have always been fascinated by the values that drive biomedical practice: as an anthropologist, as a patient, and as the daughter of a physician. When my colleague Dr. M. Ariel Cascio reached out to collaborate on a new project on medical students’ experiences around team-based learning at a school in the U.S. Midwest, I eagerly accepted the invitation. Some of the findings from that study are presented here, although we couch this qualitative data in broader conversations about efficiency as a key principle of contemporary biomedicine.

What was one of the most interesting findings?

What surprises me most is how candid that medical students and physicians have been with me about the limits of their own knowledge. It takes quite a bit of humility and vulnerability to admit when you don’t know something, and I admire those qualities very much in the participants I’ve worked with. In participants’ stories, I’ve found that ignorance and efficiency are closely linked. For instance, because medical students are confronted with so much information in their education, they need to be selective about what content to focus on most with the limited time they have to study and prepare for exams and clinical rotations. USMLE Step 1 preparation materials like First Aid market themselves in terms of efficiency, committing to being “high yield” by cutting what is believed to be extraneous information, which streamlines students’ preparation. Essentially, what can you afford to ignore or overlook to learn only what is most necessary? As my coauthors and I observe in the article, the relationship between time and knowledge persists in clinical practice where efficiency is highly prized.

What are you reading, listening to, and/or watching right now? (Doesn’t have to be anthropological!)

I just finished the book Ace by Angela Chen, which is a thoughtful, intersectional exploration of asexuality in the United States. I wasn’t expecting the book to relate back to my work in the health humanities, but there is a chapter dedicated to the intersection of disability and asexuality that I found nuanced and compelling.

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

Being an expert isn’t just about mastery of specialized knowledge. It’s also about developing keen awareness of the limits of your own knowledge. In that way, ignorance is just as much a part of expertise as knowledge. Physicians embody that principle in their work, but future anthropological research is needed to reveal how other types of clinical professionals and healers contend with not knowing.

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

Fareeda Abo-Rass, MSW, PhD, is a Palestinian-Arab social worker and researcher. She is a Research Fellow in the Takemi Program in International Health at Harvard T.H. Chan School of Public Health.

Abo-Rass’s research focuses on the psychosocial aspects of mental health among the Palestinian minority in Israel, with a particular emphasis on mental health literacy, subjective beliefs, and attitudes, and their relationship to health outcomes and behaviors. Her work seeks to uncover barriers and facilitators to mental health help-seeking among various groups within the minority, including individuals with mental disorders, women, adolescents, students, and older adults, etc..

What is your article “Unraveling Trust Issues Towards Mental Health Professionals Among Bedouin-Arab Minority in Israel” about?

The article examines the challenges of trust in mental health professionals and services within the Bedouin-Arab community in southern Israel. Through qualitative interviews with 25 Bedouin participants, the study reveals that concerns about confidentiality significantly erode trust in local Bedouin mental health professionals. This distrust is deeply rooted in cultural and social structures rather than in the professional attributes of the providers and is fueled by fears of stigmatization and potential privacy breaches. The lack of trust leads to reduced help-seeking behavior or a preference for non-Bedouin mental health providers, despite the challenges posed by cultural differences and language barriers. The findings underscore the need for culturally sensitive approaches to building trust in mental health services within this minority community and other non-Western minorities.

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

First, I am the mother of two wonderful daughters: Tulip (10 years old) and Yasmina (7 years old).
I earned my master’s and doctorate in Community Mental Health at the University of Haifa before moving to the U.S. to pursue a postdoctoral fellowship at Smith College in Massachusetts, funded by a Fulbright scholarship. In Fall 2023, I joined Harvard as a researcher in the esteemed Takemi Program in International Health.

As a Palestinian, living under ongoing conflict and war, which significantly impacts my mental health, has deepened my interest in mental health issues, particularly in understanding why the minority community I come from remains hesitant about seeking mental health care. This curiosity drove me to choose this field and focus my research on it. My community is traditional and conservative when it comes to discussing mental health, but it also suffers from institutional discrimination, leading to a severe shortage of services and professionals, as well as a lack of institutional interest in promoting awareness and improving mental health beliefs within the community. Through my research, I aspire to shed light on my community’s barriers and obstacles to mental health care, providing empirical knowledge that can inform other studies, decision-makers, and professionals.

What drew you to this project?

During a qualitative study I conducted among the Bedouin community, titled ‘Mental Health Literacy as a Barrier and Facilitator for Service Use: Qualitative Inquiry among Palestinian Bedouins in Israel,’ the topic of trust emerged frequently, even though it was not the primary focus of the research. This prompted me to conduct another study specifically focused on understanding trust towards professionals in this community in depth. Research indicates that within the Bedouin community, which is part of the Palestinian minority in Israel, referral rates to mental health services are very low despite high levels of mental distress. Therefore, I believe it is crucial to focus on this community and thoroughly examine all issues related to their mental health.

What was one of the most interesting findings?

The most interesting finding from the study is that the lack of trust in mental health professionals does not stem from their skills or performance, nor is it based on direct experiences with them. Instead, it arises from cultural and social beliefs and opinions, many of which are not grounded in personal experience but have been passed down through generations. This distrust,

initially directed at the general healthcare system, has shifted to the mental healthcare system as well. The community’s status as a minority within Israel plays a significant role in shaping this lack of trust.

What are you reading, listening to, and/or watching right now? (Doesn’t have to be anthropological!)

I am currently reading the novel “Salt Houses” by Hala Alyan. I enjoy reading books by young women writers and those that focus on indigenous people. These books offer valuable insights into history and the present, and I often learn a great deal about the mental health of different communities through them. This particular novel, a work of historical fiction that follows four generations of a Palestinian family, resonates with me as it echoes parts of my own family’s story.

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

If there was one takeaway or action point I hope people will get from my work, it would be the importance of self-reflection regarding their beliefs on mental health and mental treatment. I want people to consider whether their views are based on facts, personal experiences, or simply on information passed down through social and cultural norms. By doing so, we can significantly raise awareness and encourage communities to promote the importance of mental health and increase knowledge around it, especially when the institutions may not prioritize this within this minority.

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

Carol Chan is an anthropologist of migration and im/mobilities, racialization, and gender. She is author of “In Sickness and in Wealth: Migration, Gendered Moralities and Central Java” (2018, Indiana University Press) and co-author of “Chineseness in Chile: Shifting Representations in the 21st Century” (2022, Palgrave Macmillan) with Maria Montt Strabucchi and Maria Elvira Rios.

What is your article “Managing the Long-Term Effects of Psychological Abuse on (Im)migrant Domestic Workers” about?

This article is based on a broader ethnographic study of Filipino and Indonesian migration to Chile. Most are women who migrated primarily to work as caregivers and cleaners in private households. While researchers have highlighted the emotional distress of migrant domestic workers who experience abuse by employers, less is known about long-term effects of the psychological abuse that they experience. In the article, we analyze the experiences of three Filipino women to focus on how they narrate and manage the long-term effects of psychological abuse in the domestic workplace that they experienced more than ten years earlier. Building on insights from medical anthropology and using narrative analysis, we contribute to discussions on migrants’ mental health and psychosocial wellbeing by showing how these migrants seek to make meaningful sense of their previous experiences to deal with the enduring effects. We show that they construct alternative narratives that foreground their experiences as linked to structural factors and suggest that their psychosocial wellbeing is linked to their ability to subvert or derive meaning from earlier experiences of structural violence.

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

As an anthropologist of migration, I’m interested in how, why, when, and where people migrate, as well as the experiences and trajectories that complicate common understandings of migrants and migration. For example, when people re-migrate again and again, or when people decide to stay in a place where everyone else seems to be leaving. I’m curious about how perceptions or imaginaries of migrants and mobility influence the actual circulation of people across borders and impact the experiences of those who do not migrate or move.

What drew you to this project?

This article draws on a broader research project on Filipino and Indonesian migration to Chile that received funding from the Chilean National Agency for Research and Development (Fondecyt 11200270). When I first arrived as a new migrant from Singapore to Chile, I was surprised to find that many Filipino women had also migrated from Singapore, primarily to work as caregivers and housekeepers for wealthy families. I was curious about how their experiences as women, migrants, and workers in these two countries compared. I wanted to explore and understand these similarities and differences in greater depth.

What was one of the most interesting findings?

Although many Filipina workers were in arguably better labor and living conditions as compared to their experiences in previous countries, and had even obtained permanent residency in Chile, the lingering effects of psychological and verbal abuse from as long as fifteen years ago were still evident. One woman used the term “repress” to talk about how she dealt with how such past experiences continue to haunt the present. That conversation sparked the initial impetus for this article. 

What are you reading, listening to, and/or watching right now? (Doesn’t have to be anthropological!)

I started reading The Argonauts (Maggie Nelson), and re-read Minor Feelings (Cathy Park Hong).

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

Psychological abuse – often in the form of repeated verbal abuse-  constitutes the most common form of abuse experienced by migrant domestic workers, and it can have long-term, enduring impact that should be considered in political and collective efforts to improve workers’ labor conditions and overall wellbeing.

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

Ann Cheney, PhD, is associate professor in the Department of Social Medicine Population and Public Health, University of California Riverside School of Medicine. She is a medical anthropologist and conducts community based participatory research. Her current work focuses on the impact of structural inequalities on the health among marginalized groups.

What is your article “Continuum of Trauma: Fear and Mistrust of Institutions in Communities of Color During the COVID-19 Pandemic” about?

The article, Continuum of Trauma: Fear and Mistrust of Institutions in Communities of Color During the COVID‑19 Pandemic, is about the historical and present-day processes that shaped trauma and fear of COVID-19 healthcare services in communities of color during the COVID-19 pandemic. We conducted focus groups with historically marginalized communities, including individuals who identified with being a member of an African American/Black, Latinx/Indigenous Latin American, and Native American/Indigenous community in Inland Southern California. We found that people within these communities experienced a continuum of trauma from historically based trauma (e.g., racism, colonialism) to cultural trauma (loss of collective identity) to social trauma (race- and income-based inequities) that underlie fear and mistrust in US institutions—public health, medicine, science, government. During the pandemic, exposure to these historical and present-day traumas shaped engagement with COVID-19 public health mitigation efforts and decisions about testing and vaccination leading to continued cycles of trauma.

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

I’m a medical anthropologist and use community based participatory research approaches to carry out public health and health services research. I see research as a way to empower grassroots leaders to activate communities and change narratives of health and wellbeing. I grew up in rural upstate New York on a family-run farm, which greatly shaped my career and passion for working with farm-working communities. Since graduate school, I have worked, in various ways, with agricultural and farm-working communities.

What drew you to this project?

Over the past 10 years, I have collaborated with various communities and groups, including African Americans in rural Arkansas and Native Americans, Latinos, and Indigenous Latin Americans in Inland Southern California. In the first several months of the pandemic, I submitted a grant to the National Institutes of Health (NIH) to identify and intervene on the structural and socio-cultural barriers to COVID-19 testing and vaccination. In collaboration with academic investigators and community partners, we planned to engage historically marginalized communities in our region, Inland Southern California. The grant wasn’t funded. But the research I designed was eventually carried forward through a state-wide effort, STOP COVID-19 CA, led by UCLA and funded by NIH Community Engagement Alliance (CEAL). It was an honor to lead this work and draw from my experiences and insights gained over the years from working with various groups.

What was one of the most interesting findings?

The most interesting finding is the continuum of trauma—historical, cultural, and social—that shapes the lives of historically marginalized communities and populations. I give full credit to Dr. Evelyn Vázquez, the lead author of the article, who proposed this continuum. As a team, we fleshed it out and considered how it differently and similarly played out across the groups we engaged in our research.

What are you reading, listening to, and/or watching right now? (Doesn’t have to be anthropological!)

I am listening to the audible book The Death Gap by David A. Ansell. It is a must read/must listen book about structural violence and how it manifests with US healthcare systems.

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

Trauma is complex. Too often our healthcare systems focus on individualized trauma perpetrated by others such as intimate partner violence or sexual assault. But trauma is historical and systemic, and it is patterned by social categories like race, ethnicity, indigeneity, language. To intervene on the effects of trauma in its varied forms on collective wellbeing, we need to identify the inequities within systems and institutions that perpetuate the continuum of trauma.

Other places to connect:

UC Riverside Profile

Website

Twitter

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

Ana Vinea is an Assistant Professor in the Department of Asian and Middle Eastern Studies, University of North Carolina-Chapel Hill. She has a PhD in Cultural Anthropology from the City University of New York. Her research focuses on medical practices and religion in the Middle East.

What is your article “Psychiatry, Law, and Revolution: A View from Egypt” about?

The article examines the controversies stirred in Egypt by the passing of a human rights-based legislation in 2009, “Law for the Care of Mental Patients.” It is an important act, intended to bring the country’s mental health system—suffering from chronic underfunding and resource gaps—in line with global standards of care. Yet, as readers can discover in the article, the law was surrounded by controversies from the beginning. The article offers an analysis of these debates that reveals the diverging notions of medical authority and responsibility, patient autonomy, and the profession’s place in Egyptian society that animated them. In the aftermath of the 2011 Egyptian uprising, discussions about the 2009 law became tied with assessments about the revolutionary moment and reflections on the future of the country. In this sense, the article is concerned with this intertwinement between psychiatric reform and historical transformation. tools for assessing mental health and illness among Kannada-speaking populations.

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

For some time now, I have been fascinated with thinking anthropologically about how different ontologies, epistemologies, and forms of being in the world intermingle, coexist, or clash. At first, I pursued this theme in the domain of family structures and religious practices in Romanian-Egyptian mixed marriages. My current research engages and deepens this intellectual concern into the domain of affliction and health at the intersection of biomedicine and Islam. I am pursuing this interest in my current book project, Healing Muslims: Islam, Psychiatry, and Therapeutic Dilemmas in Contemporary Egypt, which focuses on a reformist form of spirit exorcism and the debates it has stirred in the past decades especially among psychiatrists. In the context of this research, I have also developed an interest in societal and especially medical debates, as the ones I focus on in this article.

What drew you to this project?

I came to this project unexpectedly. When I was in Cairo conducting research for the book mentioned above and interviewing psychiatrists as part of that study, I learned about the 2009 law and heard the different opinions mental health professionals had about it. While this was not really part of my main research topic, I was fascinated not just by the diversity of positions but also by the many misunderstandings on which such positions were partially based. I decided then to collect these different takes on the legislation, hoping that one day I will be able to analyze and publish something on the subject.

What was one of the most interesting findings?

I conducted this research soon after the 2011 Egyptian uprising, and from the start it was striking how divergent takes on the mental health legislation became conduits for thinking about what was going on in that hopeful but uncertain political moment. It was interesting to trace how mental health connected the political and the psychiatric, as both dealt on different levels with questions of freedom, rights, and state power. As I see it, in that fleeting historical moment, the work of reimagining psychiatry also became a way of reimagining the nation.

What are you reading, listening to, and/or watching right now? (Doesn’t have to be anthropological!)

I was recently on a long-haul flight where I watched Wim Wenders’ 2023 film Perfect Days. Such a beautiful movie! I am currently reading A Map of Home, a novel by Arab American writer Randa Jarrar. For my work I am reading Alan Klima’s Ethnography # 9 and skimming through the chapters of an edited volume called Psychiatric Contours: New African Histories of Madness.

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

I hope that the article shows how and why psychiatric reform is so complex and unpredictable sometimes, especially when it might be most needed. Listening with attention and openness to a variety of positions towards a specific psychiatric reform, in this case mental health legislation, carries the promise—if nothing more—of finding a path of change that stirs less opposition, and is thus more effective.

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

Caroline Chautems is a social and medical anthropologist. In 2020-2024, she researched cesarean birth culture in Switzerland. From October 2024, she will study queer reproductive justice and doula care in California, with a Fulbright grant. She is the author of Negotiated Breastfeeding: Holistic Postpartum Care and Embodied Parenting (Routledge, 2022).

What is your article “’I Felt Like I Was Cut in Two’: Postcesarean Bodies and Complementary and Alternative Medicine in Switzerland about?

My article is based on an ethnography of parents’ experiences of cesarean births in Switzerland, where one in three deliveries is a cesarean, one of the highest rates in Europe. I examine how women who have undergone cesareans often turn to complementary and alternative medicine (CAM) therapies to address persistent pain and discomfort from the surgery. This trend is largely due to the lack of biomedical guidelines specifically addressing these post-surgical issues.

Since CAM therapies are not typically covered by basic health insurance, this situation exacerbates care stratification. Privileged women, who have both the informational and financial resources, can access CAM therapies, while underserved groups do not benefit from this type of care.

For women recovering from a cesarean, engaging in CAM therapies not only helps relieve their symptoms but also validates their pain, feelings, and sometimes trauma. This validation allows them to reclaim their post-cesarean bodies.

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

My work focuses on reproduction, gender, parenthood, and sexualities. Through my ethnographic fieldworks, I examine how healthcare providers support reproductive processes and the transition to parenthood, shaped by parenting and reproductive public health policies. Drawing on the framework of reproductive justice, I explore how (intended) parent’s access to and experiences of perinatal care are stratified based on class, race, sexual and affective orientation, and literacy, including digital literacy. In relation to healthcare, I am also interested in birthers’ embodied experiences, particularly during the postpartum period. I investigated these topics in my PhD thesis on breastfeeding and home birthing, and in my research on cesarean culture and my article in Culture, Medicine and Psychiatry.

What drew you to this project?

This project is part of a larger study on parents’ experiences of cesarean birth in Switzerland, funded by the Swiss National Science Foundation, and in collaboration with my colleagues Prof. Irene Maffi and Ainhoa Saenz Morales (University of Lausanne, Switzerland). Within the framework of this study, I chose to focus on the post-partum period and post-cesarean recovery for several reasons.

First, compared to other stages of the reproductive process, such as pregnancy and delivery, the postpartum period remains largely understudied in both anthropological and medical research on reproduction.

In addition, from a biomedical perspective, healthcare professionals primarily focus on the baby’s health and well-being during the postpartum period, while maternal recovery is often glossed over, even after cesarean deliveries.

I aim to address this gap in both the scientific literature and in biomedical follow-ups by examining women’s post-cesarean recovery experiences.

What was one of the most interesting findings?

During my interviews with CAM therapists, the topic of sexuality frequently came up. Their discourses often embedded post-partum sexuality within cisheteronormative representations of femininity. In this context, CAM treatments were presented as a way for women to reconnect with their femininity, seen as a necessary step to resume (hetero)sexual intercourse, with CAM therapists criticizing the lack of biomedical care for cesareaned women. However, they mostly upheld the medical and social norms of mandatory and fulfilling (hetero)sexuality. I believe it is crucial to disrupt these norms and change the conversation about postpartum sexuality.

What are you reading, listening to, and/or watching right now? (Doesn’t have to be anthropological!)

I listen to many podcasts, usually during my commute or other activities. My current favorites are Code Switch, which offers comprehensive conversations about how race and racism shape every aspect of society, The Queer Family Podcast, a deep dive on queer family building with in-depth interviews of LGBTQ+ parents, and The Daily, which mixes sharp commentary of the news with thorough investigations on specific topics.

I enjoy reading Passerby, an online magazine featuring intimate portraits of women, combining photography and text and delving deep into their stories.

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

The women I interviewed generally first turned to their OBGYN to discuss their symptoms, such as persistent pain or scar discomfort, post-cesarean. They often faced a lack of consideration or downplaying of their symptoms. They then turned to CAM therapists to find some help, because they were in a privileged position and able to do so. This makes me wonder how less privileged women tackle their symptoms when they cannot access CAM therapies. My fieldwork observations highlight the need for more comprehensive biomedical follow-up after a cesarean birth. This includes involving physical therapists, who are reimbursed by basic health insurance in Switzerland. My observations and analyses also apply in other contexts presenting similar gaps in post-surgical follow-ups. However, literature is scarce on the topic of post-cesarean healthcare, and how recovery is addressed in other countries, which calls for further investigations.

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Academia

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

Wren Ariel Gould is a 3rd year PhD student at the Dalla Lana School of Public Health at the University of Toronto. They leverage critical theory, political economy, and critical psychiatry in considering LGBT mental health, with their research addressing this vital intersection (e.g., trans mental healthcare, anti-trans health legislation)

Kinnon Ross MacKinnon is an Assistant Professor in the School of Social Work. His research examines the socio-political dimensions of gender-affirming healthcare delivery and how sexual and gender minority individuals have experienced this care.

What is your article “Detransition Narratives Trouble the Simple Attribution of Madness in Transantagonistic Contexts: A Qualitative Analysis of 16 Canadians’ Experiences” about?

This article is about how accusations of “mental illness” are often used to undermine marginalized peoples, especially transgender, nonbinary, and gender-nonconforming people. One way accusations of mental illness can be leveraged to against gender minority people is through stories about how trans/nonbinary identities are not “real” because they are rooted in mental illness, and that some people detransition when they “realize” their transition was motivated by a mental illness. Our paper interviewed individuals whose personal stories reflects insights into this trajectory, highlighting that at the center of their narratives was resistance to the idea that mental illness made any part of their life story (or former trans identities) any less real or valid. These individuals sometimes reflected that earlier gender dysphoria was real, even if they have come to understand dysphoria as intersecting with mental illness or neurodivergence. Ultimately, these stories suggest that neurodivergence or mental health challenges are no reason to invalidate others and that providers of gender-affirming healthcare may look to develop approaches to care that are trauma-informed and can attend to madness.

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

Wren: I’m interested in LGBT mental health viewed from a few critical perspectives, especially critical political economy. On the one hand, that means I’m interested in how states are trying to assume control over trans healthcare, especially from the perspective of a thorny political context in the U.S. But I’m also interested a broader U.S. political context and what it means for LGBT mental health, mainly U.S. divisions between rural and urban spaces. I’m particularly interested in ideas about how urban spaces are (relatively) safe for LGBT people, especially because I wonder if that holds for everyone. I grew up in a small town in the U.S., and at least my experience was a bit more complicated than that. I’m curious if those ideas are complicated for other people and what implications that holds for the U.S. political landscape.

What drew you to this project?

Wren: I was drawn to the project because I actually have a lived experience of detransition and also years of experience as a mental health provider (informed by

Recovery and critical psychiatry). My experience was that my story was really different from stories in the media that depict detransition as a unilateral failure and as negative, and I wanted to know what others’ perspectives were. I also try to think about “mental illness” outside of psychiatric frames, as part of human neurodiversity, so I was especially curious about how neurodiversity informed detransition and how that story may not be categorically negative and could look really differently from what I saw in the news.

Kinnon: I was the principal investigator of the Re/DeTrans Canada study that provided the qualitative data for this paper. The trajectory of my scholarship for the past decade has consistently included attention to the needs of sexual and gender minority people on the margins of society. Detransition is an experience that is becoming increasingly visibilized in society, yet it remains highly stigmatized, misunderstood, and a politicized experience. In the current socio-political context, there is extreme polarization and rigid ideas surrounding what it means to be transgender or detransitioned. As a trans scholar who transitioned 15 years ago, and who has supported friends to transition, and to detransition, I am curious about these phenomena and the narratives relating to both experiences, especially pertaining to mental health discourse.

What are you reading, listening to, and/or watching right now? (Doesn’t have to be anthropological!)

Wren: I’m currently reading Lent, by Jo Walton, an historical fantasy novel about the “mad” monk Girolamo Savonarola in Renaissance Italy and somewhere between re-watching Legion (about an X-men character with multiple personalities) and The Owl House (about learning how to be a witch in the Boiling Isles and how to embrace being a weirdo).

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

When neurodivergent people speak, they deserve to be heard.

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