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

Rebecca Seligman is a medical and psychological anthropologist. Dr. Seligman studies how political-economic conditions, ontologies, models of self and personhood, narrative, and practice shape experiences of health and illness. Her published works focus on religious devotion and therapeutics, healing and self-transformation, embodiment and the intersection of mental and physical health, and the anthropology of psychotherapy.

What is your article “Mothering and Mental Health Care: Moral Sense-Making Among Mexican-American Mothers of Adolescents in Treatment” about?

The intersection of maternal care with mental health care is increasingly commonplace, yet we know little about the experience from the perspective of mothers in general and Mexican American mothers in particular. This article details the stories of Mexican American women seeking care for their troubled adolescents, and their efforts to sort out what is “right” for their children in the face of numerous competing stakes and the urgency of their children’s struggles. The article situates mothers’ narratives in the context of morally loaded discourses surrounding both mothering and psychiatry. It demonstrates that the moral threat associated with help-seeking, by forcing mothers to make sense of their situations, also gives them an opportunity to re-envision aspects of themselves and their social identities. Mothers use their experiences to create narratives of maternal expertise and valor, and as a way to engage in identity renegotiation related to gender, ethnicity, and class.

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

My work focuses on mental health and the cultural and social factors the shape the expression and treatment of distress in different contexts. I am particularly interested in how meaning is embodied and the relationship of embodied meanings to health. One of the themes I have been exploring for a long time is “the work of culture” in healing and therapy. My earliest work was on the role of ritual in healing and my first book is about the embodied therapeutics of spirit possession mediumship. But I am also interested in the anthropology of psychiatry, and the role of culture and meaning in biomedical contexts. My most recent work is on people’s experiences with an illness called Conversion Disorder, or Functional Neurological Disorder, which is widely presumed to be “psychosomatic.” But in between, I did a study on how people from different backgrounds understand and experience mental health care, which is what this article is about.

What drew you to this project?

As a postdoc in transcultural psychiatry at McGill University, I was able to participate in a cultural consultation program for clinicians that was exceptional in many ways. I got very interested in issues related to the provision of culturally appropriate mental health care. Later, when I saw statistics suggesting that Mexican American adolescents have high rates of mental health issues, I wanted to know what kind of care they were getting in mainstream mental health care settings. I had the idea to interview the parents as well as the adolescents and clinicians, to get a sense of what care-seeking was like from all of those perspectives.

What was one of the most interesting findings?

I was struck right away by how the mothers were the ones who seemed to take all of the responsibility for getting care for their adolescents, how strong and resourceful they seemed, and how their feelings about this kind of care-seeking often seemed very complicated. There’s a lot of ambivalence among mothers about engaging with psychiatry because it has major moral implications—they worry that they are, or will be seen as, “bad mothers.” But what was so captivating about many of their narratives was how they actually used their care-seeking as a way to present themselves as strong and heroic, and as a way to align themselves with different sets of values and different ways of being parents.

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

I like to read and watch fiction in my spare time. I just read a great novel called “The Quail Who Wears the Shirt” by Jeremy Wilson-–very surreal and funny and smart. And I’m eagerly

awaiting season 2 of Severance—speaking of things that are surreal! In a slightly more academic vein, I just finished listening to the Podcast, Hysterical, which is related to my current work on Conversion Disorder. I am also reading a really interesting book that blends memoir and scholarship, called “The Secret Mind of Bertha Pappenheim” by Gabriel Brownstein.

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

I think in practical terms, the analysis in the paper is relevant to how we understand factors influencing health care decision making. There is a fairly large literature on the barriers to mental health care seeking among people of Mexican origin in the U.S., but the work mostly focuses on economic and other practical barriers. Those are incredibly important, but this work suggests that barriers could also include complex social and moral dynamics. I would love to see greater clinician recognition of the fact that families from diverse backgrounds are navigating both complex social and structural constraints in order to come to the clinic.

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

Einat Bar Dror, PhD, Anthropologist and organizational sociologist. Her research deals with psychological and medical anthropology, anthropology of morality and religious conversion. Worked as lecturer in the Department of Sociology and Anthropology and in the Faculty of Medicine at the Hebrew University in Jerusalem, Israel.

What is your article “‘He Should Party a Little Less’: Evolving Orthodox Religiosities in Psychotherapeutic Interventions Among Jewish Gay Men” about?

Given prohibitions on homosexuality in Jewish law, the article explores how religious therapists navigate various contradictory commitments while deliberating which therapeutic strategy to choose.

The research, which based on 20 interviews with religious therapists, showed three practices which the therapists use: reproducing religious norms, allowing homosexuality to be privately acknowledged while advocating its concealment from the public eye, or adopting religious distinctions that enable two men to live together while abstaining from sexual intercourse. These interventions express therapists’ pragmatic cultural work, sorting out opposing therapeutic discourses, like the liberal-professional and the religious, and engaging with contestations beyond the clinic’s boundaries.

We claim that some interventions may suggest an acknowledgment that religious standards are often met only on the surface and require continual subterfuge. They may imply, however, a recognition of cracks in the religious ideal and fine-tuning of religious and professional commitments.

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

Anthropological and sociological. I’m interested in religious conversion and religious affiliation; Medical anthropology and organizational sociology. The intersection between religion, secularism, conservatism, liberalism and the moral issues that arise in these intersections are at the center of my research projects. I explore the ways in which opposing discourses struggle but also violate and change each other and lead to the formation of new cultural models.

What drew you to this project?

I got into research through a friend that worked as an instructor for religious boys who attended a religious educational program after high school. He shared with me

that he had received several requests from trainees for help due to sexual attraction to men. The boys who approached him asked him to help them “get rid of the problem” since they realized that it conflicts with Jewish law. He said that in order to help them, he made contact with a variety of religious therapists who specialize in the treatment of homosexuals, and shared with me all kinds of treatment methods that those therapists offered to his students.

This topic ignited great curiosity in me. I was interested in learning about the topic from the therapists’ point of view – to stand for their worldview and the manner in which they justify their therapeutic practices This research was fascinating for me and gave me great inspiration to continue dealing with moral issues that exist at the interface between the religious world and the Western world.

What was one of the most interesting findings?

One of the most interesting findings of the study concerns the position and the significant social role of religious therapists who treat homosexuals in the Israeli religious population. Beyond their attempts to decide between professional and religious values, the religious therapists need to navigate between the diverse voices of the religious communities to which they and their patients belong. In addition, they are also affected by pressures arising from professional and state regulations and the tense discussions in the public sphere in Israel, in social and mass media and in parliament. All of which, as I found, were very much present in the therapists’ reflection on their role and the way in which they conducted and managed the therapy.

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

I recently watched an interesting documentary called “Daughters” which follows a project that allows prisoners in the US to spend quality time with their daughters. The film raises issues of gender and race and has important social and political implications.

In addition, I Like listening to podcasts on a very wide variety of topics – including society, culture, psychology, economics, design, politics… As a music lover, one of my favorites is a local podcast called “One song” that brings, every episode the story behind one song – from the moment of its inspiration until it is released. It is excellently made and makes you fall in love with familiar songs every time.

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

In order to understand a culture, it is very useful to listen to the gatekeepers of this culture, and among them to the therapists entrusted with the health and well-being of the mind.

At the same time, it is important to remember that the therapists do not only maintain social order but also actively participate in its change.

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

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

I’ll start by saying that defining oneself in front of others always involves a bit of falsification because the self is a process of construction—a narrative. You can’t truly express the self. I think this should be kept in mind in these internet-dominated times. We shouldn’t get too attached to a self-presentation, or we may end up being enslaved by it. In any case, I’ll say that I’m Verónica, a 37-year-old Spanish researcher. I studied medicine and philosophy. I’ve completed my doctorate and have specialized in the fields of health education and critical medical anthropology. Currently, I’m pursuing two main lines of work: 1) studying violence and cyberviolence between adolescent couples with diverse ethnic, racial, and cultural backgrounds and 2) exploring youths’ experiences of loneliness from the perspective of the anthropology of loneliness. Both lines of work focus on how adolescents’ and young adults’ relationships are changing and how they impact their health and well-being.

What drew you to this project : “Understanding the Sociocultural Dynamics of Loneliness in Southern Spanish Youth”

As a professor of research methods, I often tell my students that the most important thing when conducting research is to choose topics that they are passionate about, that affect them emotionally, and that interest them enough to dedicate their lives to understanding and transforming. There is something about this quest that gives life meaning. This is what loneliness is about for me. I’ve always had a deep and complex relationship with loneliness. My academic interest in the topic predates the pandemic, but during the pandemic, many conversations I had with young people and my own experience made me want to explore it in a moment in which it could be felt more intensely: How loneliness is experienced in contexts of extreme isolation. Sometimes, understanding social phenomena in extreme situations is an effective way of uncovering details that wouldn’t be revealed otherwise. Taking things to their extremes is a way of unveiling their true nature.

What was one of the most interesting findings?

Beyond trying to understand the sociocultural dynamics of loneliness (which is what the article is about), I became aware of the pressing need that young people have to talk about this experience. Loneliness is still burdened by shame and taboos that cause young people acute discomfort, leading them to internalize a sense of guilt about their experiences. I analyze loneliness as an experience that, in many cases, is produced by the individualistic, competitive, and performance-oriented society we live in. In this sense, I believe the article highlights the need to develop policies that can ease this collective discomfort (politics of suffering and discomfort).

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

Recently, I read Mary Shelley’s Frankenstein. I have a certain fondness for the themes of disengagement/inadequacy and the construction of monstrosity. It’s a book I highly recommend. I returned to it after watching the film Poor Things by Yorgos Lanthimos.
Right now, I’m alternating between two books. For pleasure, I’m reading Goliarda Sapienza, an Italian communist poet. For academic purposes, I’m reading Kierkegaard for a seminar on loneliness and despair in his work. As for what I’m listening to and watching, I have to admit that I only listen to the radio occasionally. I don’t own a TV set or use streaming platforms. The last film I loved was Alice Rohrwacher’s La chimera.

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

I believe that the digitalization of life and relationships constantly reminds us of the importance of physical bodies and their absence. A political or social health strategy for relieving contemporary discomfort must necessarily include the recovery of physical contact and embodied connections—a politics of bodies.

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

Dr Aggarwal is a psychiatrist and social scientist. He is interested in translating anthropological theories and practices for clinical use. He also is interested in cultural analyses of knowledge and practice within the psy- disciplines.

What is your article “Patient Perceptions of Illness Causes and Treatment Preferences for Obsessive-Compulsive Disorder: A Mixed-Methods Study” about?

Our article in Culture, Medicine, and Psychiatry  makes several contributions. First, there is not a lot written about the experiences of people with obsessive-compulsive disorder (OCD) who seek clinical care. We wanted to use the Cultural Formulation Interview to elicit these experiences. Second, we wanted to see how  perceived illness causes related to treatment experiences. We think our data makes the case that providers should ask patients about illness causes and treatment preferences because how people think about the causes of their illnesses could inform what types of treatment they have accessed in the past or want now.

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

I’m interested in the anthropology of mental health and illness. Anthropology provides us with theories and ethnographic methods that critique assumptions in psychiatry and psychology. A lot of psychiatric research is devoted to neuroscience, and anthropology helps us see that the social and cultural lives of patients are also important to clinical care. In many instances, they can be even more important to clinical care than biological models of illness.

What drew you to this project?

I came late to this project. My co-authors comprise a fabulous team of accomplished researchers. Most of them specialize in more biologically oriented research, even though they are interested in social and cultural issues. They collected data on patient perspectives using a modified version of the Cultural Formulation Interview (CFI). I’ve written about using the CFI with patients. When they invited me to participate, I could not resist.  

What was one of the most interesting findings?

Cultural psychiatrists have gotten really good at crafting questions to ask patients about certain domains of culture that have clinical relevance. For instance, we have a great deal of scholarship on patient explanations of illness and treatment preferences. We have less information on how these cultural domains interrelate. So seeing how patient explanations of illness relate to past treatment preferences was really interesting.

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

I’ve gotten a paper rejected within the past week. The ideas in this paper really meant a lot to me. I go through periods of self-doubt when I get rejections. So I’m not reading, listening to, or watching anything scholarly at the moment. I’m just relaxing and engaging in self-care before I start writing again.

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

The social and cultural contexts of patients’ lives matter so much more than a psychiatric diagnosis can ever communicate.

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

Dr. NP Ngubane is an anatomist who ventured into neuroscience, indigenous knowledge systems and traditional medicine for her PhD studies. She is currently involved in teaching, module coordination and research supervision in the Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, in the College of Health Sciences at the University of KwaZulu-Natal.

What is your article “The Influence of Culture on the Cause, Diagnosis and Treatment of Serious Mental Illness (Ufufunyana): Perspectives of Traditional Health Practitioners in the Harry Gwala District, KwaZulu-Natal” about?

Traditional healing and Traditional Health Practitioners (THPs) are still perceived as “inferior” and receive contestation in the biomedical entity due to the lack of scientific backing and detailed information of how this type of healing contributes to healthcare while taking into consideration the cultural and spiritual beliefs of a community. This article then aimed to qualitatively obtain insights from the THPs’ perspective into how culture influences the explanation of mental disorders; viz. their cause, methods of diagnoses and treatment approaches used in the traditional healing practice. The focus was on schizophrenia as symptoms of this disorder are said to be caused by a calling to become a THP and are also associated with conditions involving ancestors and/or other spirits and sorcery or bewitchment in the African healing setting. This article also aimed to identify the common symptoms observed by the THPs in mentally ill patients and document the system used by the THPs to manage their patients.

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

I am an anatomist by profession. In my undergraduate studies I majored in Anatomy, Biochemistry and Microbiology, but stuck to Anatomy for my postgraduate studies. My previous research before PhD was based in cadaveric investigations, and particularly for my Masters research I investigated the anatomy of the sphenoidal air sinus. For my PhD studies I then branched into something different compared to what is common in my field. So, my current research interests are in indigenous knowledge systems, traditional/herbal medicine, mental health/psychiatry, and neuroscience.

What drew you to this project?

Being African. I have noticed that some information on traditional and cultural beliefs and practices ends up getting lost from generation to generation due to the lack of records which can be passed from one generation to the next. And having this information published plays a role in its preservation. My supervisor’s interest in indigenous knowledge systems, and how various ailments, particularly mental illness, have different causal explanations and treatment approaches is what also drew me to this project.

What was one of the most interesting findings?

One of the interesting findings is how cultural and spiritual conditions, which may be termed as culture-bound syndromes, actually align with psychiatric conditions through the symptoms observed in patients. Although conditions such as ufufunyana still have discrepancies in the description of symptoms observed in patients; as this condition’s causation is usually reported differently depending on how respondents from different studies understand it. Thus, the only difference between biomedical and traditional medicine in this regard is standardization. There is no one-size-fits-all in traditional medicine as everything relating to healing is guided by ancestors and cultural beliefs.

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

Oh, please don’t judge me. I am currently reading Act Like a Lady, Think Like a Man by Steve Harvey. And I am currently watching 1899 and King the Land (K-drama) on Netflix.

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

That would be, just because something is not fully understood, that doesn’t make it useless or inferior to what is considered to be known. Just because traditional medicine lacks scientific backing, that doesn’t necessarily mean it is void, considering that it has been used since centuries ago and is still being used by a number of communities globally.

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.

Other places to connect:
Website

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:
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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.

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