The following article is part of the Culture, Medicine & Psychiatry March 2024 special issue, “Student Experiences of Covid-19 around the Globe: Insights from the Pandemic Journaling Project” which is guest edited by Heather M. Wurtz, Katherine A. Mason, and Sarah S. Willen.

This special issue explores how the Covid-19 pandemic has impacted the mental health and wellbeing of high school and college students in diverse locations around the world. The collection analyzes data collected by the Pandemic Journaling Project, a combined research study and online journaling platform that ran on a weekly basis from May 2020 through May 2022, and from complementary projects. Contributions draw on a range of data including PJP journal entries, semi-structured interviews with PJP participants, autobiographical writing by students, and conversations about engagement with PJP in classroom and community-based settings. This week we feature a brief blog post by the authors of  “Cultivating Voice and Solidarity in Times of Crisis: Ethnographic Online Journaling as a Pedagogical Tool”.

This article is by:
Sarah S. Willen, Associate Professor of Anthropology, University of Connecticut
Kristina Baines, Associate Professor of Anthropology at the City University of New York (CUNY) Guttman Community College and affiliated faculty at the CUNY Graduate School of Public Health and Health Policy 
Michael C. Ennis-McMillan, Associate Professor of Anthropology at Skidmore College

Photo 1: Skidmore College students, isolated in quarantine, viewing campus activities from a window (2022).

What is your article “Cultivating Voice and Solidarity in Times of Crisis: Ethnographic Online Journaling as a Pedagogical Tool” about?

In our piece, we discuss how online journaling – in general, and using the Pandemic Journaling Project (PJP) platform in particular – became useful for teachers and students at the height of the COVID-19 pandemic. Our essay synthesizes a series of conversations among three educators who specialize in medical anthropology: one of PJP’s co-founders and two anthropology faculty who taught with PJP in multiple classes at their respective institutions. We show how PJP gave students a chance to use ethnographic approaches to document their pandemic experiences – not just for themselves, but also as a forward-looking form of “archival activism.” At a time when participant-observation and other traditional teaching strategies had become impossible, PJP helped students learn from, connect with, and think critically and analytically about the pandemic experiences of people who were both similar to and also very different from them.

Tell us about how this project came to fruition.

After learning that both Kristina and Michael had begun teaching with PJP, Sarah brought the crew together for a sustained conversation that started with one-on-one conversations, followed by an online panel about the pedagogical value of online ethnographic journaling (at the 2021 Society for Applied Anthropology Annual Meetings) and eventually the three-way dialogue that became this co-authored essay.

What was one of the most interesting findings?

We were struck by the ways in which ethnographic journaling can help students appreciate what it means to bring your “whole self” to your ethnographic work – and how doing so can create new forms of data and insight, challenge mainstream misconceptions, help ease distress, and even – in some instance, have therapeutic benefit. Students documented a range of critical and creative pandemic responses that broaden understanding of a global health emergency.

Who might be interested in reading your piece?

We expect that anyone who lived through the first years of the COVID-19 pandemic, and especially people who were either students or educators (or both) during that time, will see aspects of their experience reflected in the piece. We hope that students who read it will come away with a better understanding of how much teachers scrambled to understand students’ experiences, connect with their students, and teach well under extraordinarily difficult circumstances. And we hope that educators who read the piece, especially those in anthropology and other qualitative social sciences, will see how online ethnographic journaling can serve as a valuable teaching and learning tool and that students’ voices offer valuable contributions to studies of pandemics.

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

We recognize that lots of people don’t want to think about COVID anymore, or think about it right now. But when you are ready to think about it, we think our piece can offer useful insights on the value of online journaling in classroom settings. We also think it can help folks see the value of bringing PJP’s searchable Featured Entries page into your own teaching and learning experiences. In addition, our article will orient future scholars now that the PJP archive (housed at the Qualitative Data Repository) is open to external researchers.

The following article is part of the Culture, Medicine & Psychiatry March 2024 special issue, “Student Experiences of Covid-19 around the Globe: Insights from the Pandemic Journaling Project” which is guest edited by Heather M. Wurtz, Katherine A. Mason, and Sarah S. Willen.

This special issue explores how the Covid-19 pandemic has impacted the mental health and wellbeing of high school and college students in diverse locations around the world. The collection analyzes data collected by the Pandemic Journaling Project, a combined research study and online journaling platform that ran on a weekly basis from May 2020 through May 2022, and from complementary projects. Contributions draw on a range of data including PJP journal entries, semi-structured interviews with PJP participants, autobiographical writing by students, and conversations about engagement with PJP in classroom and community-based settings. This week we feature a brief blog post by the authors of “The Eschucha (Listen) Podcast Project: Psychosocial innovation for marginalized Mexican youth and young adults”.

This article is by:
Cristopher Bogart Márquez Rodríguez, Master’s student in Psychosocial Intervention, Department of Psychology, Catholic University of Colombia

What is your article “The Eschucha (Listen) Podcast Project: Psychosocial innovation for marginalized Mexican youth and young adults” about?

The “Escucha” (Listen) Podcast Project” describes an innovative intervention project based in Mexico City, which sought to provide psychosocial support for young people in contexts of social exclusion. Youth participation in the project entailed weekly journaling with the Pandemic Journaling Project (PJP) — an online journaling platform and research study. Youth also engaged in weekly phone conversations with a member of the intervention team to give youth a space to express themselves and reflect on their lives and experiences. Regular and frequent communication with youth participants throughout the project helped foster a sense of trust towards the intervention practices and the intervention team. The project culminated in the creation of a podcast, in which each participant created a 2-5 minute chapter for the podcast about their experiences during the pandemic.

Tell us about how this project came to fruition.

Violence in Mexico has grown exponentially in recent years; one of the population sectors hardest hit by increasing violence is young people — especially those who live and coexist in contexts where violence is the daily norm. This sector is particularly vulnerable to different types of risks linked to material conditions and poverty. Despite increased need, there is a lack of emotional and therapeutic support programs that operate in marginalized communities. In my experience of around 13 years working with vulnerable groups, acting early can help prevent the reproduction of violent behavior. One of the objectives when intervening within these communities is to trigger cognitive processes that promote critical perspective of structural inequity, help youth reevaluate their abilities and potential, and strengthen their self-esteem. Bringing together the easy-to-use, digital platform of PJP with our own psychosocial tools allowed us to engage youth in these cognitive processes through dialogue, writing, and other creative outlets.

What was one of the most interesting findings?

One of our most interesting and important observations during the course of the project was the impact of the intervention on participants’ sense of wellbeing, as they described in  both one-on-one conversations with team members, as well as in their journals. For young people who contend with overlapping forms of exclusion, it can be difficult to help them gain access to and engage in therapeutic spaces. But feeling truly listened to, for youth, can have a far-reaching effect. One of the project participants who had been incarcerated prior to the project and found the intervention particularly insightful, commented to an intervention team member: “If I had done something like this when I was younger, if someone had listened to me like this, with attention and without judging me, maybe my life would have been different.”

Who might be interested in reading your piece?

This article will be of interest to health professionals attracted by research and development of innovative, non-traditional projects aimed at young people in contexts of social exclusion.

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

We can conclude by recognizing the impact of creatively-driven, contextually appropriate mental health interventions for youth. Socio-emotional work with young people in marginalized contexts in Mexico is not common, however, providing alternatives for support and professional accompaniment – ​​as was done through this work – has made a notable difference in strengthening self-esteem among the youth participants.

The following article is part of the Culture, Medicine & Psychiatry March 2024 special issue, “Student Experiences of Covid-19 around the Globe: Insights from the Pandemic Journaling Project” which is guest edited by Heather M. Wurtz, Katherine A. Mason, and Sarah S. Willen.

This special issue explores how the Covid-19 pandemic has impacted the mental health and wellbeing of high school and college students in diverse locations around the world. The collection analyzes data collected by the Pandemic Journaling Project, a combined research study and online journaling platform that ran on a weekly basis from May 2020 through May 2022, and from complementary projects. Contributions draw on a range of data including PJP journal entries, semi-structured interviews with PJP participants, autobiographical writing by students, and conversations about engagement with PJP in classroom and community-based settings. This week we feature a brief blog post by the authors of  “Seesaw Precarity: Journaling Anxious Hope on a Chinese University Campus During Covid-19”.

This article is by:
Katherine A. Mason, Associate Professor of Anthropology, Brown University
Jianmei Xie, Lecturer in Second Language Education, School of Foreign Languages, Guangdong Polytechnic Normal University

Photo 1: Photo from journal entry by study participant, April 14, 2022, Guangzhou, China

What is your article “Seesaw Precarity: Journaling Anxious Hope on a Chinese University Campus During Covid-19” about?

“Seesaw Precarity” is based on the Covid-19 experiences of a group of Chinese university students. We draw on journal entries that the students submitted to the Pandemic Journaling Project to argue that these students spent most of their undergraduate years living in a state of “seesaw precarity.” We define seesaw precarity as a long period during which many people in China were unable to predict from one day to the next whether they would be free to engage in the ordinary, everyday activities of everyday life. We trace student reactions and adaptations as they struggled to attend class, buy food, and see friends and family in the midst of unpredictable swings between openness and closedness. The seesaw nature of restrictions spurred anxiety among the students we followed, but also produced an optimistic mindset we refer to as “anxious hope.”

Tell us about how this project came to fruition.

This project resulted from a partnership between the co-authors that traces back to 2002, when we first met in Guangzhou, China to do a Chinese-English language exchange. We became friends and then colleagues and have kept in close touch over the years. We kept in touch during the pandemic, and we knew from our own correspondence that both professors and students were having really different experiences in China vs. the US. When Heather and Sarah and I (KAM) decided to put together a special issue on student experiences of the pandemic, I (KAM) thought immediately of reaching out to Jianmei (JX) to see if she’d be interested in writing something. She was, and we began meeting to put together the project that forms the basis for the paper. It’s been such great fun collaborating on this project and this article after so many years of more informal collaborations!

What was one of the most interesting findings?

I think both of us were pretty surprised at just how resilient the students we followed seemed to be during all of the crazy ups and downs of the pandemic in China. Jianmei had noticed and remarked on this before we even started the project, as she worked very closely with dozens of Chinese undergraduates during this time and frankly was amazed at how much better they seemed to be handling things than the adults in her life! We had talked about this before and then both observed it strongly in the data. The students were definitely struggling, and periodically did get upset, but they were really determinedly optimistic about the whole thing in ways that were quite inspiring.

Who might be interested in reading your piece?

I think our piece should be of interest to anyone who would like some deeper insights into lived experience during the pandemic in China. We get such a stilted, superficial view of people’s lives there through US media, and the focus is almost always on negative experiences and on resistance. Our article certainly doesn’t discount people’s negative experiences, but also provides a bit of a more well-rounded sense of the full lives people were leading, and how they managed to find joy in addition to the sorrow. We also provide some insight into why there was relatively little resistance to harsh control measures in China during the first two years of the pandemic.

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

One big takeaway from this article is that people can handle an awful lot of uncertainty even over long periods of time, if they have faith in the system and are able to experience their chaotic situation as something that will make them stronger rather than break them. But this ability and willingness to weather a lot has limits. A lot of people started to hit their limit in China in late 2022, when the really strict control measures that they were living with started to work less and less well in controlling the virus, and the cycles between locking down and opening up became more frequent and more extreme.

The following article is part of the Culture, Medicine & Psychiatry March 2024 special issue, “Student Experiences of Covid-19 around the Globe: Insights from the Pandemic Journaling Project” which is guest edited by Heather M. Wurtz, Katherine A. Mason, and Sarah S. Willen.

This special issue explores how the Covid-19 pandemic has impacted the mental health and wellbeing of high school and college students in diverse locations around the world. The collection analyzes data collected by the Pandemic Journaling Project, a combined research study and online journaling platform that ran on a weekly basis from May 2020 through May 2022, and from complementary projects. Contributions draw on a range of data including PJP journal entries, semi-structured interviews with PJP participants, autobiographical writing by students, and conversations about engagement with PJP in classroom and community-based settings. This week we feature a brief blog post by the authors of  “‘You would think she would hug me’: Micropractices of Care Between First-Generation College Students and Their Parents During Covid-19”

This article is by:
Andrea Flores, Vartan Gregorian Assistant Professor of Education, Brown University
Kate Mason, Associate Professor of Anthropology, Brown University

Photo 1: The first gen research team presents their work at the Society for Applied Anthropology annual conference in Santa Fe, New Mexico.

What is your article “‘You would think she would hug me’: Micropractices of Care Between First-Generation College Students and Their Parents During Covid-19” about?

Our article is about first-generation college-going families’ attempts to care for each other’s mental well-being during the pandemic. We call these efforts “micropractices” of care, or the “little things” we do for each other like offering a drive, buying a small “treat,” listening, or offering a kind word. Sometimes these micropractices had the desired effect, and sometimes they did not. By closely examining these micropractices, we show how mental wellness is formed in the space between people in everyday, but critical ways.

Tell us about how this project came to fruition.

This project was a small pilot we conducted to see how parents and first-gen college students navigated the balance between the immediate challenges of the pandemic and long-term educational plans. Coming out of the pilot, we more closely examined how mental wellness in the present was tied to keeping the family aligned on shared future goals.

What was one of the most interesting findings?

Some of our most surprising findings from our longitudinal interviews two years after initial student journaling included the multiple ways that students adapted and thrived over the period of the pandemic and the benefits to university learning that many students identified that could be applied to improve access to higher education throughout Mexico. Numerous participants described the personal benefits of the adaptability of virtual learning that allowed for greater exploration of personal and professional projects while also allowing students to have greater flexibility with fulfilling their university coursework. Many participants emphasized the potential for virtual learning platforms to play a key role in overcoming social inequalities within access to higher education in Mexico. They identified that virtual platforms could potentially improve opportunities for some students to access a broader range of specialties and coursework, particularly for students living in rural parts of Mexico.

Who might be interested in reading your piece?

Our most interesting finding was the importance of matched expectations regarding a given micropractice. We found that when there was alignment and understanding between the motivations behind a caretaker’s efforts and the cared-for’s response, mental wellness was preserved. When there was disjuncture and misunderstanding, mental wellness was harmed.

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

We hope that folks who work with first-gen students—as instructors, deans, counselors, physicians—would be interested in reading this piece, as well as first-gens themselves!

University staff who work with first-gens need to integrate understanding about the webs of relationships first-gens manage into their practice. Understanding students’ progress in school cannot be separated from their family ties.

The following article is part of the Culture, Medicine & Psychiatry March 2024 special issue, “Student Experiences of Covid-19 around the Globe: Insights from the Pandemic Journaling Project” which is guest edited by Heather M. Wurtz, Katherine A. Mason, and Sarah S. Willen.

This special issue explores how the Covid-19 pandemic has impacted the mental health and wellbeing of high school and college students in diverse locations around the world. The collection analyzes data collected by the Pandemic Journaling Project, a combined research study and online journaling platform that ran on a weekly basis from May 2020 through May 2022, and from complementary projects. Contributions draw on a range of data including PJP journal entries, semi-structured interviews with PJP participants, autobiographical writing by students, and conversations about engagement with PJP in classroom and community-based settings. This week we feature a brief blog post by the authors of  “Thriving Despite the Odds: Digital Capital and Reimagined Life Projects Among Mexican College Students During COVID-19”.

This article is by:
Heather M. Wurtz, Post-doctoral Research Fellow, Pandemic Journaling Project, University of Connecticut/Brown University.
Maria Hernandez, MA, El Instituto: Institute of Latina/o, Caribbean, and Latin American Studies, University of Connecticut
Madeline Baird, PhD Candidate, Department of Anthropology, University of Connecticut

Photo 1: “Quédate en casa. Mayo de 2020” (Stay at home. May 2020) / José Antonio Cervera Jiménez / May 2020 – Mexico City. Photo from Picturing the Pandemic photo exhibition in Mexico City, MX.

What is your article “Thriving Despite the Odds: Digital Capital and Reimagined Life Projects Among Mexican College Students During COVID-19” about?

Our article, “Thriving Despite the Odds,” examines ways that Mexican college students leveraged technology to cope with and overcome challenges related to prolonged school closures and other hardships during the pandemic. The study draws on in-depth interviews with and journals of 12 college students who participated in the Pandemic Journaling Project (PJP) – an online journaling platform and research study that chronicles everyday life during COVID-19. We found that by using technology to support their current and future endeavors, such as finding new ways to connect with others and to expand their professional skills, students experienced a renewed sense of purpose in their educational activities. For many, their engagement with technology also provided a source of coping with emotional distress, particularly in the way that it supported their ability to imagine a positive post-pandemic future – for both themselves and broader society.

Tell us about how this project came to fruition.

In the early months of the pandemic, nearly 50 college students from Mexico joined PJP and journaled periodically on the PJP platform for a time period spanning a few weeks to over 50 weeks, for some students. Their journals provided an important window onto the everyday experiences of students as they coped with the rapid transition to online learning along with a host of new challenges created by the pandemic, such as intensified caretaking roles and the illness and loss of loved ones. These insights raised compelling new questions for us about how students’ educational trajectories shifted or were reworked over time as a result of the pandemic and continuing hardships. All three of the authors have regional expertise in Latin America and recognized a unique opportunity for exploring changes in Mexican students’ lives and educational paths through follow-up interviews with PJP participants. The combined use of journals and interviews paints an illustrative picture of students’ experiences over the first two years of the pandemic, shedding light on the key role that technology played in students’ ability to adapt to and overcome adversity during a time of crisis.

Photo 2: “Staring at Doves” / Yolanda A. González G / April – June, 2020 – Mexico City. Photo from Picturing the Pandemic photo exhibition in Mexico City, MX.

What was one of the most interesting findings?

Some of our most surprising findings from our longitudinal interviews two years after initial student journaling included the multiple ways that students adapted and thrived over the period of the pandemic and the benefits to university learning that many students identified that could be applied to improve access to higher education throughout Mexico. Numerous participants described the personal benefits of the adaptability of virtual learning that allowed for greater exploration of personal and professional projects while also allowing students to have greater flexibility with fulfilling their university coursework. Many participants emphasized the potential for virtual learning platforms to play a key role in overcoming social inequalities within access to higher education in Mexico. They identified that virtual platforms could potentially improve opportunities for some students to access a broader range of specialties and coursework, particularly for students living in rural parts of Mexico.

Who might be interested in reading your piece?

Our article is written for anyone seeking to understand students’ experience during the global pandemic. Students worldwide experience a drastic shift from in-person to online learning. However, many students also found ways to cope and cultivate new ways of learning. Anyone reading this article will find that while many students struggled to adapt to online learning, some also found ways to develop and leverage their digital competencies for their future and to create a more equitable society. In addition, our educational leaders and policy readers may find these articles insightful in finding ways to promote and develop educational policies that support students’ online learning.

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

For the students in our study, levering digital competencies and resources played an important role in their ability to maintain and adapt their life plans during a time of crisis. Their use of technology buffered their life plans not only in terms of expanding possibilities for future careers, but also for enriching their present lives – for example, by fostering their relations with others. These findings suggest that digital capital may promote college perseverance, especially in conditions that place constraints on in-person interaction. Digital competencies may also provide a source of coping with mental health distress by helping students cultivate a sense of human connection and belonging. While this is promising for some students, it also points to the potential role of technological disparities in intensifying social and health inequalities. These findings underscore the importance of closing digital divides, especially among marginalized communities already facing structural inequity.

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?

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.

Other places to connect:
Website

Linkedin

TikTok

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

Giulio Ongaro is a Fellow at the Centre for Humanities and Social Sciences at the Southern University of Science and Technology in Shenzhen, China. Additionally, he is a Visiting Fellow at the Department of Anthropology, London School of Economics and a Team member at Program in Placebo Studies at Harvard Medical School. He obtained a PhD in Social Anthropology from the LSE and a MSc in Philosophy of Mind from the University of Edinburgh.

What is your article “Doctors Speak: A Qualitative Study of Physicians’ Prescribing of Antidepressants in Functional Bowel Disorders” about?

The article explores how gastroenterologists in a US hospital prescribe tricyclic antidepressants to treat irritable bowel syndrome and the challenges they face in doing so. IBS is a functional disorder (a chronic condition with no precise pathophysiology) which is often surrounded by stigma. Prescribing low-dose psychiatric medication, albeit proved to be effective, can be stigma-inducing because it potentially hints that the disorder is “all in the head”. To avoid this, physicians gravitate their explanations towards the known neurophysiological mechanisms of action. Though avoiding psychological talk, their engagement with patients is nevertheless sensitive to the psychology of expectations, which they know can powerfully affect clinical outcomes (when realistic). They thus place a lot of effort in building and managing hope in patients. Overall, the study shows how physicians do their best to help under specific cultural assumptions – about mind and body – that make functional disorders so hard to treat within modern medicine. 

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

My research lies in the areas of medical anthropology, cross-cultural psychiatry, and healing ritual. As part of my PhD at the LSE, I did long-term ethnographic fieldwork among the Akha people of highland Laos. I researched their shamanic tradition and medical philosophy, focusing on healing efficacy: on how rituals work and how people think they work. Alongside fieldwork, I have conducted research within the science of ‘placebo effects’ and surrounding areas of philosophy of cognitive science and psychiatry. In collaboration with researchers at the Program for Placebo Studies at Harvard Medical School, I have published on the mechanisms of placebo and nocebo effects and on cultural narratives around medicine-taking, including this highlighted article.  

I’m currently on a fellowship at SUSTech in Shenzhen. What’s nice about it is that gives plenty of academic freedom, so I’ve ended up delving into a somewhat disparate set of topics. I’m writing an article on the notion of ‘externalist psychiatry’, one on downward causation in neuroscience, and one on a shamanic movement that took hold in Laos while I was there. I’ve also kept an interest in global history (rekindled recently by the publication of Graeber and Wengrow’s The Dawn of Everything). Trying to bring all these strands together, I am writing a book on the global history of medicine that centres on the epistemic and therapeutic value of animistic healing traditions.   

What drew you to this project?

It was an invitation from Prof. Ted Kaptchuk and his team at the Program of Placebo Studies at Harvard Medical School. The Program investigates ‘placebo effects’ from an interdisciplinary perspective, bridging clinical sciences with social sciences and humanities, so my research interests fitted in quite well. Dr. Sarah Ballou – who shares first-authorship of the article – conducted interviews with physicians at a Boston hospital on various aspects of prescription of tricyclic antidepressants for IBS (as part of a broader project on how physicians approach functional gastrointestinal disorders). Together with Dr. Julia Haas, we analysed the central themes, which touched on the implications of giving physiological and psychological explanations of functional disorder and its treatment. These are also topics that I investigated ethnographically in highland Laos among the Akha. So, the study for me was also interesting from a cross-cultural point of view.  

What was one of the most interesting findings?

It was the care physicians took to avoid stigmatising narratives by centring their explanation on the neurophysiological processes of treatment. For instance, they’d talk about ‘neuromodulators’ rather than ‘antidepressants’; ‘nerve sensitivity in the gut’ rather than psychological factors involved in IBS. All the same, much of their approach showed a deep awareness of the importance of realistic expectations and hope in treatment, i.e., psychological factors. Though it fell outside the scope of the article, to me the fact that these physicians (who are among the best in the country in this field) had to tread so carefully on this complicated mind/body terrain speaks of some theoretical limits inherent to the biomedical approach to functional disorders. I found this interesting comparatively speaking. Many medical traditions around the world (the Akha being one) do afford rich conceptual resources for dealing with disorders that would be diagnosed as ‘functional’ within biomedicine. Typically, they externalise their causes onto the social environment. In so doing, they pre-empt the kind of stigma that the physicians we interviewed actively try to avoid in the clinical encounter. So, as an anthropologist this study was interesting for highlighting the big role played by culturally-specific explanatory frameworks surrounding the treatment of functional conditions.   

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

I have been reading Starhawk for a course I am teaching on the anthropology of magic and healing. Fiction, I have just finished A Man’s Place by Annie Ernaux. Having a long commute, I’ve been listening to a fairly random mix of podcasts like Red Medicine, Hermitix, Srsly Wrong, Tides of History, COMPLEXITY and Mad in America. The last movie I watched was The Banshees of Inisherin and the last song played was by Rosalía. 

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

That the main way to make progress in psychiatry will depend on externalising mental disorders: on casting both the causes and treatment of psychiatric disorders, partly, onto the social environment. This won’t be the consequence of giving up on the brain, but of knowing more about it as an organ of mediation. And that other healing traditions illuminate the kind of social conditions that enable externalisation (though all this is not something I’ve already written; it’s something that will hopefully come out soon). 

Other places to connect:
Twitter
LinkedIn
Academia
Research Gate

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

Ellen E. Kozelka is an Assistant Professor, Anthropology Department, University of Vermont. She is a psychological/medical anthropologist and Global Mental Health Scholar. Her research focuses on cultural conceptions of mental health and illness, specifically how those conceptions shape both available treatment options and health seeking behaviors for systemically marginalized populations in the US and México.

What is your article “Living the Process: Examining the Continuum of Coercion and Care in Tijuana’s Community-Based Rehabilitation Centers” about?

I explore why researchers must attend to cultural conceptions of health issues that expand beyond biomedical frameworks; doing so gives us the opportunity to understand the different forms of knowledge that aid or harm treatment at the individual level. By exploring one community-based (non-biomedical) treatment center’s institutional position on the therapeutic value of coercion, I highlight a different perspective on addiction’s “root problem” as well as how coercion has been incorporated into the proper method to treat that condition. I then examine several cases in which coercion was effective from women’s own perspectives as well as when it was not, challenging dominant assumptions about experience in coerced care while emphasizing its messy ethical and therapeutic reality. In doing so, I present both a method and justification for Global Mental Health researchers to attend to cultural context in a way that will promote equitable engagement with community partners around best care practices.

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

My work examines how structures of inequity shape the formation of, access to, and experience in mental health care systems for marginalized populations in the US and México. I specifically examine why marginalized people seek out novel and “nontraditional” care options to understand how healthcare systems could be made more equitable and welcoming to all.

What drew you to this project?

This article is based on my research in community-based substance use treatment for ethnically Mexican women in the US-MX border zone. Through this work I explored the question: why are there such diverse experiences of treatment and recovery, even within the same community-based therapeutic model? My driving question was straightforward, yet revealed both the complexity and importance of understanding cultural ideas of health and illness, moral ideas of personhood, and the intersection of individual experience with structural forces. My research contributes to the assertion that “addiction” is an individualized biopsychosocial illness, as is the healing process of recovery. As such, available treatment options should be variable enough to match this continuum of experience.

What was one of the most interesting findings?

To me, one of the most interesting elements of this work has been learning the specific reasons why women use drugs, the wide range of reasons and ways they end up in compulsory treatment, and what that tells us about how culture shapes mental health experience for marginalized women in the US and México. By exploring multiple treatment and recovery trajectories, I discuss possibilities for ways to reshape care and contribute to health equity for marginalized women.

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

I currently reading “The Best Minds: A Story of Friendship, Madness, and the Tragedy of Good Intentions” by Jonathan Rosen and watching “Traitors”.

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

I hope that my work demonstrates that anthropological methods and attention to cultural context can be used to bridge gaps in understanding about different forms of mental healthcare in ways that foster equitable collaboration, both across academic/professional disciplines and stakeholder groups.

Other places to connect:
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