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

I have worked at Surrey University for a little over 25 years and am currently a Professor in the School of Social Sciences. I am also the Editor-in-Chief of the journal Sociology.

What is your article “Entanglements of Technologies, Agency and Selfhood: Exploring the Complexity in Attitudes Toward Mental Health Chatbots” about?

A few years back, Christine Hine and I became really interested in conversational agents (chatbots) for mental health – and we wanted to know more about how people formulate their understandings of what might be appropriate in this space. We decided to interview a group of non-users who had experienced a need for support; as this group could imagine self as a therapeutic target unconstrained by the features of a specific actual chatbot. Focus groups started with a brief description of mental health chatbots before turning to discuss expectations, assumptions, understandings and attitudes.

With respect to some core findings, multiple forms of imagined ‘agency’ were operationalized within participant narratives. The most common was a form of agency where chatbots are treated as one dimensional objects which could enable people to achieve their goals. Chatbots were also afforded a ‘parasitic’ agency, as well as derided for having no agency.

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

Following my social science Masters degree I joined the Human Psychopharmacology Research Unit at the University of Surrey. At the time, this was one of Europe’s largest sleep labs and I found myself increasingly interested in the sociological aspects of sleep. To this day I remain immensely grateful that I then bumped into Professor Sara Arber. At that time there was not much sociological work happening in this area – although Simon Williams at Warwick certainly needs a mention here – and Sara had just started working on a sociological study of women’s sleep. I ended up doing a part-time PhD under Sara’s supervision, working with her on a study of couples’ sleep and publishing a range of papers on inequalities and sleep. The sociological aspects of sleep remain one of my core research interests and I am currently co-editing a collection on the global history of sleep and dreams and working on a project looking at adolescent sleep and mental health.

What drew you to this project?

There is also probably quite a long story here. Although being interested in sleep sounds quite focused, in reality it has led me to travel into areas ranging from health and medicine to family and masculinities. A lot of my current research happens at the nexus of sleep, technology and mental health. This project was formed in that space in the Venn diagram where technology and mental health touch and where I am particularly interested in the meanings of recovery and how these are shaped by – and shaping – technologies.

What was one of the most interesting findings?

I might be cheeky here and offer two. One of the concluding points in the article is that a range of traditions, norms and practices are used when people think about chatbots for mental health. Taking this forward might help us understand why there is such complexity in research on user attitudes and experiences.

The other thing I found really interesting is hidden a little in a footnote. One of the participants talked about using ChatGPT as a form of therapeutic tool. When alone, they would sometimes ask how it is, ask if it could suggest a song to help them feel peace and calm etc. If I am honest, at that point this hadn’t occurred to me as a possibility and raised a lot of exciting questions.

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

I am dipping in and out of Tony Blair’s book On Leadership. I feel I should say this is not because I am a Blairite (or a scholar of leadership). Blair came to power during the final weeks of my undergraduate degree and it really did feel like a huge event; not least of all because he seemed to be listening to a sociologist (Giddens).

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

Across my work – which often speaks to different disciplinary audiences – it is probably just that we ‘need to think beyond the individual’. Of course, I also hope that some of the complexities around ‘why’ and ‘how’ travel through but we probably have a bit more work to do here.

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

I am a cultural/psychological anthropologist with research interests in emotional distress and mental illness. Publications include individually authored studies of postpartum depression and borderline personality disorder and team authored studies of post-traumatic stress disorder. My work is motivated by an aim to apply anthropological concepts and methods toward mental health recovery.

What is your article “Stubborn Families: Logics of Care of a Family Member with Borderline Personality Disorder” about?

This study explores what care for a family member with borderline personality disorder (BPD) looks like in practice, according to parents’ and siblings’ narratives. I find the care efforts described in involved family member narratives merits our recognition—these were all stubborn families offering unwavering support—and our concern. Examination of their care leads to the fundamental understanding that family recovery cannot be an either/or situation. Rather, both the person with the mental health condition and the family members need supports to foster recovery. This work aims to register the critical importance of family recovery and the absence of explicit, culturally inflected moral norms and the deficient structural supports for this goal.

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

Over the past several years, I have been studying emotional distress, related mental health diagnoses and recovery. Research in Rio de Janeiro on reproductive health led me to examine women’s struggles with perinatal depression and anxiety and what helped them recover. I next worked on a qualitative project of a Minneapolis Veterans Affairs research team to understand what went wrong for veterans who either quit or didn’t benefit from evidence-based psychotherapy for Post-Traumatic Stress Disorder. The current project concerns family member experiences of BPD at differing moments: parents’ growing awareness that their child’s distress isn’t garden variety adolescence, but something more/other; ongoing familial care struggles (the focus of this article); demoralization besetting parent caregivers when care doesn’t seem to help.

What drew you to this project?

I was drawn to the project from growing up with experiences leading me to find that mental illness has a significant impact on the whole family. For some time, my study of the topic was confined to reading memoirs and attending AAA sessions on mental illness. While completing a post-doc in epidemiology and community health, I realized I wanted to do research on how BPD affects families. While the public health literature on family “burden” of mental illness is extensive and worthwhile, thematic analyses of qualitative research missed important dimensions, that I found I could capture by eliciting and analyzing narratives of family experiences of BPD.

What was one of the most interesting findings?

I started interviews by reminding interlocutors that my focus was on family member experiences of BPD and then asked “Where do you think it makes sense to start?” The outpouring of stories of multiple mental health crises suggested families acted mostly in isolation from professional, community and cultural supports. Late in the interviews, when I asked how it all had been for them, people spoke very briefly and generally. Afterwards, it struck me that familial care took place without supports for or even mention of family recovery.

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

Don’t get me started! One fine memoir is Laura Flynn’s Swallow the Ocean, which conveys the experiences of young children whose mother lives with a serious mental illness. I have tended not to read short stories, but recently found this was a mistake when I read Alistair Macleod’s Island and Claire Keegan’s Foster and Small Things Like These. Both are devastatingly beautiful. Less by Andrew Sean Greer and Drive Your Plow Over the Bones of the Dead by Olga Tokarczuk are delightful stories with unforgettable narrators.

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

I hope that from reading the work people will deepen their understanding that mental illness has repercussions on the whole family. The main takeaway I wish for readers is to register that the family members of relatives with BPD whom I got to know were trying very hard to do the best they could, with almost no infrastructure of safety, guidance or respite under situations of risk and from a place of societal misunderstanding. A significant omission in our conceptualizing of care practices of family members of a relative with BPD is recognition of supports they need, both to provide better care, as well as for their own recovery.

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

Dr. Vaishali Raval’s research, teaching, and service focus on promoting global psychological science. Situated within contextually grounded global mental health, her research program focuses on developing culturally informed understanding of psychopathology as well as processes such as parenting, emotions, and developing culturally relevant intervention and prevention approaches.

What is your article “Training in Cultural Competence for Mental Health Care: A Mixed-Methods Study of Students, Faculty, and Practitioners from India and USA” about?

Our article describes the extent to which clinical and counseling psychologists in two diverse and complementary contexts, India and USA receive training in cultural competence. Based on surveys and focus groups, we found that trainees in India learn about cultural competence more through their diverse life experiences and clinical experiences, while those in USA learn about it through varying levels of coursework, as well as through clinical experiences. In USA, cultural competence training seems to be narrowly focused on a white, cis male perspective, and does not incorporate the experiences of trainees with diverse racial, sexual and gender identities. In both contexts, trainees highlight the enormity of cultural competence and how much there is to learn, while those in the US also highlighting the hesitancy in engaging in diversity related discussions. We conclude by outlining recommendations for training programs.

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

Informed by my lived experiences across communities in India, Canada, and USA, my program of research focuses on cultural foundations of psychological processes, with a focus on mental health. As an undergraduate student in psychology at the University of Toronto, I realized the narrow focus of psychological science on people living in the Global North, and limitations of such an incomplete science. This led me to pursue graduate training in clinical developmental psychology and then postdoctoral fellowship within the interdisciplinary setting of the Department of Comparative Human Development at the University of Chicago to learn about cultural psychology. For the past 17 years as a faculty member at Miami University, I have been fortunate to work with undergraduate and graduate students and collaborators from India to advance the scholarly understanding of mental health problems like depression, anxiety and suicide, and to develop culturally relevant interventions.

What drew you to this project?

A hallways conversation with a colleague at Christ University in India, Dr. Baiju Gopal, laid the foundation for this project. I visited their university and was able to tour the psychology department where I met him, and we exchanged business cards. Then, we met over Skype to think about possible ways to collaborate. We submitted a grant proposal to the United States-India Education Foundation and it was funded!

What was one of the most interesting findings?

For me the most interesting findings are the insights from our participants: When you grow up in diverse communities in India, you begin your journey towards cultural competence as a child, and as one of the participants commented, trying to teach someone to be culturally competent after they enter college might be too late because they might be set in their ways. Diverse life experiences early on can build a foundation for life-long learning in cultural competence. Insights from students in USA with minoritized identities are also very important: when cultural competence is taught, the assumption is that the therapist is white, cis, and straight working with clients with minoritized identities. Space needs to be created for trainees with diverse identities, their experiences, and trainee needs.

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

I have been reading about decolonial theory and particularly the ways in which current psychological science practices may serve to recreate colonial inequalities. Two special issues of the Journal of Social Issues (Readsura Decolonial Editorial Collective, 2022) have been instrumental in helping me to learn about how we can move towards decolonial scholarship in psychology.

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

Developing cultural competence is a life-long process that requires the mental health practitioner to seek out professional development opportunities to continue to grow. Graduate coursework can provide a foundation that the practitioner can build on to engage in continuous learning.

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Elizabeth Fein is Associate Professor and Chair of the Department of Psychology at Duquesne University. She is the author of Living on the Spectrum: Autism and Youth in Community (NYU Press, 2020) and co-editor of Autism in Translation: An Intercultural Conversation on Autism Spectrum Conditions (Palgrave, 2018), and is the singer in Pittsburgh darkwave band Take Me With You. 

What most excites you about becoming the Associate Editor at CMP?

This journal has been one of the foundations of my whole professional identity and way of thinking. I feel like I’ve been invited into the backroom of my favorite bar. It’s really a thrill to be able to participate more actively in the making of a space that I’ve gained so much from over the years.
 

How has CMP shaped your own career? Do you have a favorite CMP article from the past that we can paste a link to here?

Probably the CMP article that I know the best is this one: “Social defeat and the culture of chronicity: or, why schizophrenia does so well over there and so badly here” because I teach it almost every year, in both my graduate and undergraduate courses. It’s a big, important argument that has many different pieces to it, and I think only a journal like CMP would be able to hold space for all those pieces to hang together. My most-cited article is in CMP as well (“Making meaningful worlds: role-playing subcultures and the autism spectrum”) – it tells a big, weird, wonderful story that fit perfectly under the expansive CMP umbrella.

What are you most excited about with your own work right now?

Figuring out ways for clinically-minded people to incorporate culture into our psychological constructs. Experimenting with new forms of writing and other kinds of expression. Working with some really sharp-minded, compassionate and creative students.

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

Piranesi by Susanna Clarke just turned my mind inside out. Reading it felt more like having a life experience than reading a book. There’s a musician from Vermont who records under the name Dutch Experts who I’m really into these days. My band Take Me With You was supposed to play a show with her, but we had to cancel. Stupid COVID. hemlocke springs, Haute & Freddy are two other current favorites.

Any quick advice for aspiring young clinician/social scientists?

Hold on to your joy.

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

I am a sociologist interested in the politics of mental health policy in Latin America. My research examines how service users, health workers, and policymakers approach core normative categories such as “human rights,” “community,” and “participation.” I utilize sociological systems theory and post-Marxist political philosophy, empirically drawing on ethnography and oral history.

What is your article “Psychiatric Experiments with “Community” Under Dictatorship and Authoritarianism: The Case of the Protected Commune Experience, 1980–1989” about?

This paper explores the paradoxical existence of the “Protected Commune” (PC), a unique therapeutic initiative within Chile’s El Peral psychiatric asylum during the oppressive military regime from 1973 to 1990. This period saw the dismantling of emergent plans for deinstitutionalization and mental health reform initiatives, the banning of community-based mental health approaches, and the silencing of progressive psychiatrists through torture and exile. Amidst this authoritarian repression, the Protected Commune emerged as a unique attempt to transform El Peral Psychiatric Asylum into an isolated microcosm, mimicking a real town with new relationships running parallel to traditional hospital hierarchies to simulate the life of an “outside” that was no longer accessible. This case study is part of an ongoing project aiming to develop a global genealogy of “community” as imagined and implemented in the context of psychiatric reform in South America, under hostile political and social conditions.

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

My work addresses ongoing debates at the intersection of two broad shifts in the politics of knowledge in global mental health. These shifts pertain to 1) the evolving role of service users and individuals with lived experience in mental health science and policy and 2) the recognition of the “global south” as a site of intellectual originality and a source of lessons in global health for the wider world. These interlocked shifts represent an epistemological and political challenge to traditional understandings of pathology and treatment and to the institutions implicated in their global circulation, mostly based in the Global North.

What drew you to this project?

After graduating in sociology in Chile, I started working in social services supporting persons with psychosocial disabilities. In the interface between the social sciences and mental health policy,

psychiatric asylums and their transformations emerged as a crucial object of attention. On the one hand, plans for the transformation of psychiatric care are directly shaped by wider political and social transformations, making this process a powerful site for sociological analysis. At the same time, the social and cultural aspects of deinstitutionalization are often concealed under a traditional public health perspective, especially in South America, and therefore a sociological perspective has the potential to contribute to policy solutions in the area.

What was one of the most interesting findings?

The Protected Commune experience was, in itself, an interesting finding. I started this project with a wider question about psychiatric reform and its interaction with the dictatorship in Chile. It was in that context that interviewees mentioned the initiative, and after this, I partly refocused the project in order to learn more about it.

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

I’m reading a book by Michael Löwy called Fire Alarm: Reading Walter Benjamin’s “On the Concept of History,”translated and published by Verso in 2005. This work by Löwy is a great introduction to Benjamin’s thought, a key author to understand how notions and usages of “history” are related to present struggles.

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

You cannot transform institutions without understanding their history. A key aspect of that history includes the previous attempts to transform them, which are always many in the case of psychiatric asylums.

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

Cristina Archetti has been researching, publishing and teaching about the role of the media and communication in politics and society for over 20 years. She is also a psychotherapist specialized in trauma. She is committed to using the full range of her knowledge to help create a more caring and inclusive world.

What is your article “Infertility as Trauma: Understanding the Lived Experience of Involuntary Childlessness” about?

Infertility, to those who are affected by it, is much more than whether one manages (or not) to have a baby: it can be a traumatizing experience. “Infertility” does not only refer to being barren (a rather rare condition) or having medical problems to conceive. It also relates more broadly to “childlessness by circumstance”: remaining without children because life just turned out that way. For example, because one does not have a partner, was ill during fertile years, because assisted reproduction never worked, among many other possibilities. Based on a study that involved psychotherapy sessions and interviews with women who are childless not by choice, the article argues that there is an urgent need to treat infertility as trauma. Not only is infertility potentially traumatizing in itself, but it might also nest within previously existing traumas. This understanding supports better care for many individuals whose long-term suffering would otherwise remain unacknowledged and untreated.

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

Over the past 20 years I have investigated phenomena as diverse as the role of the media in terrorism and radicalization and the construction of silence around infertility, among many others. I have always been driven by the questions: How do we explain the mediated reality we live in? How do we know what we know? I am particularly drawn to what might seem “invisible” and “hard to research about.”

Trauma, something that is unconscious and not accessible by its very nature, and infertility, one of the last taboos of the 21st century, are cases in point.

What drew you to this project?

I am myself childless not by choice. I was drawn to studying trauma and training to become a psychotherapist because I wanted to attend to with my own wounds. Having experienced first-hand the benefits of trauma therapy, I wanted to bring them to others. This is why I am practicing as psychotherapist beside my academic job and writing about what I am learning along the way.

What was one of the most interesting findings?

Infertility can be a traumatic experience, both in itself and in connection with previous traumas. Losing an entire future and an imagined identity as a parent—a whole trajectory of life which will never materialize—can also be a source of trauma. Although my article is about women, this affects both women and men.

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

I am watching “Encounters” (directed by Yon Motskin, 2023) on Netflix, a documentary about close encounters with non-human intelligence. Regardless of whether one believes in the existence of aliens, it provides a fascinating insight into human experience and the devastating consequences that arise, for many of the people who report having had experiences they could not explain, from being silenced, shamed and subject to stigma.

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

We need to take the trauma of infertility seriously, particularly by bringing the experience of those affected at the centre of our research and therapeutic practice.

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

I am an Associate Professor in Psychiatry at the University of Parma. My main field of interest focuses on clinical and phenomenological psychopathology under an interdisciplinary perspective. In particular, my research aims at bridging ethology, psychopathology and anthropology in the search of the evolutionary trajectories underlying human speciation. The evolution of specific human traits, such as a fully symbolic language, are in fact sedimented in psychopathology as well as in material culture. On the other hand, uniquely human traits also have a behavioral and biological scaffolding, rooted in the phylogeny of our species. Therefore, a cross-disciplinary perspective may contribute to highlight the subjective structures of our mind, shaped by complex bio-cultural feedbacks.

What is your article “The Evolution of Symbolic Thought: At the Intersection of Schizophrenia Psychopathology, Ethnoarchaeology, and Neuroscience” about?

My article aims at comparing symbolic activity, as expressed in schizophrenia psychopathology, with symbol making, as witnessed in ethnoarchaeological records. The core concept is that the uniquely human capacity for symbolic representation evolved through the exploitation of diffuse sensorimotor networks within constructed eco-cultural niches. The high plasticity and flexibility of sensorimotor grounding allows us to detach ourselves from actual contingencies and open up to a self-constructed world of symbols. However, less constrained neural pathways also mean an inherent vulnerability to a complete sensorimotor dysconnectivity, which may eventually lead to schizophrenia disembodiment.

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

My research aims to shed light on those basic structures of human subjectivity that, although unique, manifest themselves in different contexts, and are therefore generally investigated from different perspectives.

In particular, I am interested in ritual behavior from ethology to human cultures, through the interface with psychopathology. In particular, in psychopathology rituals are not limited to Obsessive-Compulsive Disorder but spread across different clinical syndromes, from developmental years to adulthood. Their study allows highlight the underlying continuity of ritual behavior, as to proximate and ultimate mechanisms, across phylogeny, as well as their pivotal role during human development.

Another research interest is the human capacity for symbolic representation. Namely, my field concerns the evolutionary and developmental pathways from pre-symbolic forms of communication to symbolic language, focusing on the complex interplay between sensorimotor and language processing, which contributed to mark the split from our ancestors. The study of the evolution of specifically human traits may represent a key point to understand specifically human psychopathological conditions, such as schizophrenia and autism spectrum disorders. In this regard, an integrated motor-language-self profile might represent a reliable biomarker for the early detection of psychotic vulnerability.

What drew you to this project?

Different interests over time merged together within a psychopathological framework. Psychopathology, in particular its phenomenological approach, is inherently open to interdisciplinary exchanges.

What was one of the most interesting findings?

The findings of my article, through a comparative approach, hint at invariant formal characteristics of symbolic processing in humans, which may be equally found in schizophrenia delusions as well as in human cultures.

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

Not really separate from my research interests, is my passion for climbing and mountaineering, which has allowed me to explore different countries and cultures and of course myself. I am just reading a beautiful novel: “Paths of glory”, by Jeffrey Archer, about the life of George Leigh Mallory and his unfortunate expedition to Mount Everest in 1924.

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

The paper strongly highlights the importance of an interdisciplinary approach in answering fundamental questions such as: “what made us humans” or “how we got here”. Within a fruitful dialogue among different disciplines, psychopathology may be in a privileged position, as it lies at the interface between nature and culture. Psychiatric disturbances in fact may contribute to unveil, often in a magnified or distorted way, such basic subjective structures of human mind, to which research should be oriented.

**Vincent Laliberte’ is the winner of the 2024 Culture, Medicine and Psychiatry Early Career Development Award for the paper shared below. Congratulations, Vincent!**

I began as a psychiatrist and later developed a passion for anthropology. I lead a clinic within Welcome Hall Mission’s shelter in Montreal, where we serve people experiencing homelessness and mental illness. Through ethnography and writing, I explore how people seek to thrive and discover ways of living in the urban environment

What is your article “When Multispecies Ethnography Encounters a Shelter-Based Clinic: Uncovering Ecological Factors for Cultural Psychiatry” about?

This paper builds on my long-term ethnography with horse-drawn carriage drivers in Montreal, focusing on one individual, whom I refer to as Jerome, who became homeless after the city outlawed the carriage industry. I explore the role of “ecologies,” by which I mean all that surrounds a living being, including relations with people, animals, plants, and digital technologies, as well as places and their affordances, in shaping psychic life. I refer to these as “ecological factors” and show how they extend beyond the social or cultural contexts outlined in the DSM. Additionally, I examine how my dual roles of psychiatrist and ethnographer were shaped by different ecologies, namely a shelter-based clinic and a horse stable. Thinking through ecological factors reveal the importance of spaces of care and what is available in the urban environment to support people’s well-being.

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

Early in life, I developed a daily practice of writing, blending life experiences with my readings, in pursuit of self-actualization. Ethnography was a revelation, showing me how writing could expand beyond the personal, immersing me in the lives of others and in the rich and multi-generational anthropological conversation. Ethnography’s grounding in lived experience, which unfolds dynamically in a milieu, also invites us to rethink dominant knowledge systems and challenge what is taken for granted. I aim to bring this ethnographic lens to community psychiatry, reimagining how we understand psychic distress and exploring new approaches to healing that are rooted in relational and ecological perspectives.

What drew you to this project?

Last winter, I attended the 2024 Association Psychopathological Association Conference in New York, which focused on the impact of sociocultural context and social determinants on mental health. Yet I felt that something was missing from the understanding of context presented there. I wanted to find a way to write about the clinical encounter that would give texture to the singular lives of people, more-than human relations, and concrete situations as they unravel. I also wanted to show the usefulness of including myself as both psychiatrist and anthropologist, as one character in those ethnographic descriptions, with my own doubts and uncertainties.

What was one of the most interesting findings?

I discovered that people are opaque, not only because we don’t know everything about them but also because there is something fundamentally indeterminate about what they could be in a given context or ecology. Getting to know another might involve meeting them in different places and in the context of various activities. In this sense, I show how the psychiatric interview room is not a neutral place where an objective view of the other is possible. Using a “view from afar,” to use Claude Lévi-Strauss’s famous phrase, I propose that the clinic is a peculiar environment that makes diagnostic process possible.

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

I am currently reading A World Beyond Physics by Stuart Kauffman and am fascinated by his proposition that something intrinsic to life, down to the molecular level, escapes the constraints of physical laws. This perspective opens up reflections on indeterminacy, and perhaps freedom, at the very core of life itself.

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

Human beings thrive in rich environments that allow them to express themselves and develop new capacities. To genuinely support healing, we need to put much more emphasis on places and what is available in them. This would lead us to create environments that foster mental health and support individuals in their journey away from suffering and toward growth and fulfilling connections. 

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

Diederik Janssen is doctoral student at the Graduate School of Arts and Social Sciences, Maastricht University, the Netherlands. Janssen obtained medical (MD) and anthropological (BA) degrees and focuses on medical history, specifically its various intersections with gender/sexuality studies. He is past (co-)founding editor of two journals including Culture, Society & Masculinities (2009-2016).

What is your article “Dhat Syndrome East and West: A History in Two Acts” about?

This article explores the early history and prehistory of dhat (semen loss) syndrome, one of the most widely researched Cultural Concepts of Distress (as the DSM-5-TR has it). Dhat syndrome experts invariably refer to both ancient Ayurvedic and analogous European notions of “semen loss”. Both references merit closer inspection. The turn from somatic-hygienic to psychiatric constructions of “semen loss” evident in the mid-1950s nomination of this “culturally determined neurosis” very much recalls a similar turn in Western medicine between roughly the late eighteenth through early twentieth century. Ubiquitous nineteenth-century verdicts such as “imaginary spermatorrhea” can be cited as evidence, and help understand the post-Ayurvedic, medical-anthropological turn of Indian semen loss anxieties as an assertion of sexual modernity in replay. At the same time, this concept of distress may reflect not so much ancient Ayurveda as the enduring commercial success, rather, of an amalgamation of colonial-era Indian and European ethnophysiologies of semen.

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

I am broadly interested in the life cycle of notions of suffering and sensibility, specifically their historical emergence across the health and life sciences. Cultural biographies of purportedly discrete types of distress show health professionals and patients struggling to inhabit the conceptual apparatus they co-author during the clinical encounter. Identities (personal, professional, national) are made up during this writing process. Medical history reminds both professional and patient of their creative roles, past and present.

What drew you to this project?

Compiling a multilingual etymological dictionary of gender and sexuality studies as a side-project, I was frustrated by not being able to get hold of an often-cited but seemingly rarely read 1960 (or 1959) text by N. N. Wig (1930-2018), the purported place of coinage of “dhat syndrome”. I may have triggered some unforeseen cultural sensibilities among my contacts; in any case I am still on the lookout for this text. I was also struck by the present-day survival of the historical European term “spermatorrhea” in traditional Chinese medicine and among Ayurvedists.

What was one of the most interesting findings?

In a footnote to a 1991 article in Culture, Medicine, and Psychiatry, Alain Bottéro (1954–2014) expressed his puzzlement over encountering a curious bit of andrological wisdom (“forty drops of blood make one drop of semen”) in both Indian sexual ethnography and eighteenth-century anti-masturbation tracts. This being an aphorism of Avicenna directs attention to the as yet poorly researched medical history of sexuality in pre-Independence India.

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

I am currently hunting references to what is colloquially known as blue balls in seventeenth-century medicine, guided by the informed guess that they have to exist. For laughs, I am perusing Ernest Borneman’s hilarious Sex im Volksmund: der obszöne Wortschatz der Deutschen (2 vols., 1971).

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

Sexual physiology and sexual hygiene have always been two sides of the same coin, with pride and sanity awarded to conformists, and crushing hypochondria to sinners. Seminal truths (Joseph S. Alter’s expression) persist when and as long as they are profitable: markets, nations and reputations are built around them. Sometimes sexual lore is unmasked as scaremongering, creating a new market of soul-saving. And sometimes this unmasking drops out of memory so hard that it repeats itself seemingly unbeknownst to most stakeholders. In the case of dhat syndrome, this may be seen to animate the scattering of post-Independence professional identities along lines of andrological, anthropological, and psychodynamic knowledgeability. 

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

I am a sociologist specializing in sociology of health and health care. My particular focus is on psychiatry and specifically I specialize in researching the research on schizophrenia. I find the instability of the idea of schizophrenia absolutely fascinating and I read the primary biological research and continue to find the results being generated there indicative of a number of cultural biases that imbue the biological project of psychiatry with an unwarranted optimism. Overall I think ‘schizophrenia’ tells us far more about cultural values and prestige generation in science and medicine than it does about something called schizophrenia. I am fascinated by how differently the biology of severe mental illness is interpreted than is, for example, the biology of grief.

What is your article “No Ordinary Scribble: The Person Diagnosed with Schizophrenia Paints Their Soul” about?

I first started reading about schizophrenic art and art brut when I worked in an antiquarian bookstore and these books with amazing artwork would pass across my desk. At first I was simply enamored, but as I learned more about the intimate relationship between representation and interpretation I became suspicious and decided to search for the empirical basis of this work. While I expected to find work that was problematic I was very surprised that there was no empirical foundation for the idea that the artwork of a diagnosed schizophrenic represented their diagnosis. This led me to survey the writing on the subject and trace the growth of the assuredness of the connection in the psychiatric literature.

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

The main goal of my work is to participate in the critical review of reductionist work in psychiatry. I find that abstraction too often overrides a human, caring encounter between practitioner and patient. This is a problem central to the research as well and I consider the ongoing individualistic reduction of the social and narrative aspects of severe mental illness both dangerous and empirically unwarranted. I am currently using the literature on social defeat to review the significant downturn in the numbers of patients diagnosed with catatonic and chronic schizophrenia in the mid-twentieth century, which, according to psychiatrists at the time, was mostly due to an improvement in institutional conditions and the implementation of occupational therapies. This suggests that a kind of social defeat was being generated in patients in the stultifying, dreary and oppressive institutional conditions of the period. It was only when patients started showing radical improvement through an improved milieu that it became evident as to just how much harm had been caused by the environment.

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

I mostly just read material relevant to my research or teaching. The last novel I read was Dawn by Octavia E. Butler which I enjoyed as it explored some very interesting questions about being human, and oppressed in the context of an alien takeover. It also examined some questions about biological identity and gender fluidity. At night I generally watch some brain candy, a British mystery or something of the sort.