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

Elisa holds a Ph.D., MSc, BA, and Bachelors in Social Work. She is a Postdoctoral Researcher at the Medical Anthropology Research Center at the Rovira i Virgili University. Her doctoral thesis focused on severe mental disorders and family care in the domestic space. Her research activity and interests are mental health, history of mental institutions, care, gender inequalities, and youth and drug addictions., Elisa is an Associate professor at the Universitat Rovira i Virgili, located in Tarragona, Spain RV.

What is your article “Unraveling Reactionary Care: The Experience of Mother-Caregivers of Adults with Severe Mental Disorders in Catalonia” about?

In this article we looked at how many undocumented migrants visiting a low-threshold free non-governmental health service had mental health problems. Undocumented migrants are a diverse group comprised of amongst others rejected asylum seekers or labor migrants without a visa. They do not exist officially, cannot work legally, often have poor and uncertain housing conditions, and have in practice a restricted access to health care due to logistical and cultural barriers.

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

I am Argentine, I was born in Buenos Aires, and for almost 20 years I have lived in Spain, where I received a degree in Social Work, a bachelor’s degree in Social Anthropology, a master’s degree in Medical Anthropology, and a year ago I finished my doctorate specializing in mental health. In my thesis, I compare the old asylum system of the total institution type and the domestic space, specifically with people diagnosed with SMI (especially schizophrenia), caring families, and mental health professionals.

In recent years I have worked on various topics, from LGBTIQ rights to religious confessions in Catalonia. My interests have also always been focused on health, specifically mental health, either from the history of mental institutions, as well as the work on schizophrenia, and drug use in adolescents, as well as the application of feminism and gender perspective in research projects. In recent times I have focused a lot on the analysis of care for people with SMD. On the other hand, I am also a social worker, so it is very important to me that the research is designed to transform reality, and that it has a real social impact on people’s lives; I place myself in applied and critical medical anthropology.

What drew you to this project?

I have been interested in this project because it involved participatory qualitative research with patients’ users of medication, caring families, and mental health professionals. In this sense, both the study subjects and the research topic were very close and connected to my doctoral research.

It was the first initiative in Europe of the “collaborative management of medication” (CMM), a cultural adaptation of Gaining Autonomy and Medication Management, developed in Quebec (Canada) and Brazil. The most attractive and important thing about this project is its real capacity to have an impact on the well-being of patients, in fact, some evaluations of the GAM initiative in Canada have found benefits such as rationalization of spending on anti-psychotics, reduced risks derived from overmedication, and improved patient satisfaction.

What was one of the most interesting findings?

In this project, we established three clear dimensions that, due to how they are experienced by the three agents in question (the patient, the caregivers, and the professionals), pose obstacles to the collaborative management of medication: the secondary effects of mediation, the (un)awareness of the disorder, and coercive models of communication.

We found it interesting that there is a palpable problem of indeterminacy surrounding the medication, the disorder, and the patient’s self that depicts a scenario of anticipation, suspicion, and mistrust. This setting paves the way for coercive practices and hinders the collaborative management of anti-psychotic medication.

The patients highlighted a social and clinical failure to recognize them as individuals with autonomy and agency. Caregivers’ perceptions of those affected as “vegetables”, “pieces of furniture”, including claims that they are grieving because their previous child has died (prior to diagnosis), all of them are expressions of structural coercion.

This coercion is found in the practice of care by the mothers or other relatives. One of the points we analyze in this article is that gender mandates on mothers’ caregivers promote coercion, surveillance, and control of their children. For this reason, we cannot understand institutional violence, that project some ways of coercion to domestic space, without gender-based violence. We analyzed how gender mandate and institutional violence operate in the ways that care is given in the domestic space.

If we want to promote a model of collaborative management of antipsychotic medication, we must encourage a new culture of care and recovery with all the actors involved, including taking into consideration the multiplicity of voices and perspectives among patients, caregivers, and clinicians. And, if we also want a change in care culture, we need to break the dual relationship between the two parties and the responsibility that it entails must be opened up to other actors and consequently to collective care.

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

Now I’m finishing the book by Marcos Obregón, “Contra la diagnóstico” (Against The Diagnostic). It is an autobiographical book that narrates the entire process, not only of the illness, but also the relationship with the clinic and institutions, and with its closest networks as relatives and friends. I think it is a brilliant book because it is also an ethnography, the author interviews various close people, some psychiatrists, psychologists, etc. who lived with or close to him through his bipolar crisis. It is a highly reflective, sensitive book, but above all, it is a necessary book, not only for people who are going through or have gone through an episode of subjective suffering, it is a book for life that everyone should read.

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

The most important of this research is the “Guide for the Collaborative Management of medication” http://llibres.urv.cat/index.php/purv/catalog/book/477 (open access an English translation). It provides tools for greater empowerment of patients, as well as is an element to think about and analyze their personal and contextual situation, enhance self-knowledge, as well as be a guide to promote greater dialogue and negotiation with professionals. It also accompanies a whole reflection on the side effects of medication and the emotional, social, and physical health consequences that these may have. They are also invited to think about their support network and assess the close networks they have, for example, if they wanted to undertake a process of discontinuation, change, or reduction of medication with the professional’s accompaniment. Although the guide is designed for medication users, it is also a tool for professionals who want to transform their ways of relating to patients and practice a more horizontal, less hierarchical, more dialogical, and negotiating clinical attention. It is also a useful tool for caregivers who want to accompany their relative in processes that may involve changes in medication but also to better understand the discomfort and suffering that surrounds drug use, the side effects, and their consequences. In summary, the guide promotes that the agents involved have active and respectful listening and that they can better attend to the needs that drug users have, and aim for a better being in health, social, emotional, and relational life, among others.

Thank you for your time!

Other ways to connect:
Twitter
ResearchGate
Orcid

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

Burcu Mutlu is an assistant professor in the Department of Humanities and Social Sciences at Özyeğin University. She completed my Ph.D. in 2019 in History, Anthropology, and Science, Technology & Society at MIT. She has published on trans/national politics of assisted reproductive technologies, reproductive labor, abortion politics, reproductive justice, and migration.

What is your article “Between Solidarity and Conflict: Tactical Biosociality of Turkish Egg Donors” explores the complex and ambivalent aspects of Turkish egg donors” about?

My article explores the complex and ambivalent aspects of Turkish egg donors’ involvement in transnational egg donation between Turkey and Northern Cyprus. The article drew on ethnographic fieldwork and interviews I conducted with Turkish egg donors at a private Northern Cypriot fertility clinic from November 2014 until January 2016. In this article, I investigate how young Turkish women tactically manage social relations and orient themselves in this morally ambivalent and precarious bioeconomy of egg donation. To do so, I particularly focus on possibilities of cooperation and conflict among egg donors who are part of a specific form of biomedical sociality. I argue that cross-border egg donation retains both gendered moral and economic concerns for these young women that must be tactically negotiated not only to protect this new (clandestine) realm of financial opportunity but also to navigate the wider context of heteropatriarchal sexual culture and restrictive reproductive biopolitics.

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

I completed my Ph.D. in 2019 with a dissertation entitled “Transnational Biopolitics and Family-Making in Secrecy: An Ethnography of Reproductive Travel from Turkey to Northern Cyprus.” In the dissertation, I investigated the transgressive cross-border reproductive travels between Turkey and Northern Cyprus that are stimulated by legal restrictions in Turkey, from a cultural anthropological and feminist STS perspective. I obtained my B.A. degree in Political Science and International Relations from Marmara University and my M.A. degree in Sociology from Boğaziçi University. Currently I am working on informal breast milk sharing practices via online platforms in times of politicized reproduction and a global pandemic. My research areas include: anthropology of reproductive technologies and biobanking; medical anthropology; feminist science & technology studies; family, kinship and gender; and transnational mobilities.

What drew you to this project?

My research interest in cross-border gamete donation is related to my M.A. project. In my thesis, I examined the local practice of assisted reproduction as a global biotechnology and its reflections on the lives and bodies of married heterosexual Turkish women (since assisted reproduction is only accessible to married heterosexual couples using their own gametes) as an intimately gendered and embodied reproductive experience. For the thesis, I conducted semi-structures interviews with married Turkish women as past or current fertility patients, and I also collected and discursively analyzed a variety of ethnographic materials including legal documents, religious discourses, economic policies, and media representations corcerning IVF in Turkey. I found that the “appropriate” and “inappropriate” forms of assisted reproduction are simultaneously configured in and through these local socio-technical articulations within and beyond the labs and clinics; transnational gamete donation thus emerges as a site of “reproductive excess” that is left outside the sphere of legality.

In my M.A. project, I investigated complex socio-technical processes that produce this excess in Turkey, with particular focus on the “appropriate” uses of assisted reproduction. In my PH.D. study, I studied this excess itself, by particularly focusing on the clandestine network of transnational gamete donation between Turkey and Northern Cyprus that includes the circulation of recipient couples, gamete donors, medical experts and technology, expertise, and capital. My article on Turkish egg donors resulted from this wider disseration project.

What was one of the most interesting findings?

I found interesting that although most Turkish egg donors I talked to said that they would support the legalization of egg donation in Turkey for recipients, they did not want donating eggs to be legally permissible for donors owing to their suspicions about the health sector in the country as well as their concerns about the possibility of higher competition (and therefore lower payment) among egg donors. So, they were willing to keep this new realm of financial opportunity secret, while undertaking all risks involved.  

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

Recently I am watching Pantheon, animated sci-fi TV series on uploaded intelligence. It raises interesting questions on what it means to be human, how the boundaries between life and death get blurred beyond the limits of corporeality, and what social, economic, political, and intimate implications technologies have for both individuals and wider society. I also enjoy reading short stories by Turkish writers and my recent favorites are Melisa Kesmez, Aylin Balboa and Burçin Tetik. Finally, I would like to mention a podcast that I recently discovered on the weather changers/ weather modification on BBC (https://www.bbc.co.uk/programmes/p0ddvpy2?utm_source=aposto ), thanks to Zappa Zamanlar, a blog curated by two Turkish sociologists, Biray Kırlı and Zafer Yenal from Boğaziçi University.

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

One takeaway or action point people can get from my work would be to criticize and challenge states’ efforts of criminalizing or banning gamete donation that drive such practices further underground within and beyond the national borders and put both recipients and donors at risk for victimization and exploitation. Bottom-up efforts or regulations are needed that would not only guarantee safe medical practice but also address underlying social processes and inequalities, with a critical perspective that accurately captures diverse voices and experiences of involved actors.

Other places to connect:
Website
Academia.edu

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

Anaïs Ogrizek is a psychiatrist, M.D, Ph.D and Fellow in Child an Adolescent Psychiatry at the Cohin Hospital in Paris, France. She received her MD at Paris V University and did her residency in Psychiatry at the University Hospitals of French West Indies, and holds a Master’s degree in Transcultural Psychology from Paris XIII University. She focuses her research on often overlooked communities of vulnerable populations in order to raise the scientific community’s concern on their condition and suggest ways to improve them.

What is your article “The Cultural Hybridization of Mothering in French Prison Nurseries: A Qualitative Study about?

My article is about how women incarcerated during pregnancy or along with their babies in French prison nurseries are being deprived from their original cultural environment. They go through a process close to creolization regarding their maternal cultural habits, with in the end the emergence of a specific hybrid culture around motherhood, even though they gather multiple factors of vulnerability for full prisonization, as a form of forced assimilation to prison culture. The results originate from a qualitative study led in 13 different prison nurseries in France: 25 mothers and 5 pregnant women were interviewed and interpretative phenomenological analysis was used to explore the data.

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

Passionate about traveling, I became interested in transcultural psychiatry early on in my career. After a successful education some of which was spent in London and New York, I decided to pursue my medical studies at Paris V Descartes University in France. During my six years of study there I completed internships in both India and Canada, as well as a one-year Erasmus exchange in Hungary. After completing my general medical curriculum, I decided to specialize in psychiatry and travelled to French overseas territories to complete my residency. In French Guyana I took part in child psychiatric missions in Amerindian villages and worked in general psychiatry in Martinique.

Following my return to Paris, I achieved a master’s degree in transcultural psychology before completing a PhD research in psychology on the theme of the “motherhood in prison”, with a specific focus on cultural traditions around motherhood. Since then, I have been taking on a fellowship training program in Child and Adolescent psychiatry at the Maison de Solenn, Cochin Hospital in Paris, known worldwide as a place of expertise in transcultural psychiatry.

I am currently working on mothers that have left prison with their children after spending some time with them in prison nurseries, in order to explore how they readjust to their lives as free mothers on every level (on personal and domestic ones as well as social and cultural ones of course). On cultural aspects, our main hypothesis based on our prior results is that the cultural gap created by prison between these women and their outside community regarding traditions around motherhood could lead, at their release, to issues similar to those faced by migrant mothers: they might become migrant mothers from an inner to an outside prison world.

Based on my prior results of motherhood in prison nurseries, I am also working on a new and more general concept of “the baby function” – as a parallel to the term of “maternal function” commonly used – in the sense of what the baby can offer to his mother, or at contrariwise what he fails to offer. I intend to develop this innovative concept in a future article.

What drew you to this project?

I have always found the carceral environment very intriguing, with often multiple entanglements with psychiatric problematics, regarding the endorsement of responsibility for one’s personal action but also regarding institutional organization that have been put forward by the emblematic Goffman in his book “Asylums”. When I randomly discovered that babies were born and raised by their mothers in such an institution I immediately wanted to know more about these mothers’ experience as it aroused so many questions regarding so many different fields of research: personal, domestic, social, cultural, judicial, and ethical.

What was one of the most interesting findings?

The most interesting finding was to observe that no matter where in France these mothers were incarcerated (Metropolitan France or French oversea territory), they all seemed to show a similar cultural hybridization to some kind of ‘‘motherhood prison culture’’ regarding motherhood habits.

I am currently reading the thrilling work by Orna Donarth “Regretting Motherhood: a study” I recently watched and loved “Woman” a film by Anastasia Mikova, and Yann Arthus-Bertrand. I also very much enjoyed Yann Arthus-Bertand’s previous film “Human”.

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

I am currently re-reading ‘Snow Falling on Cedars’ by David Guterson which takes place on the islands neighbouring Vancouver and UBC. It is an excellent book but a harrowing story about the Japanese internment camps during World War II. This is also an often overlooked part of Canadian history.

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

I would say that this work shows once again how culture is a fundamental need for every human being, and how no matter how hard an ethnic group is oppressed, he will put all its strength in making some of its culture survive in some way or another.

Thank you for your time!

Other places to connect:
LinkedIn