**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. 

Other places to connect:

Research Gate

Twitter

Facebook

Linkedin

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. 

Other places to connect:
Website

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.

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.

Other places to connect:
Website

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.

Other places to connect:
Linkedin

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.

Other places to connect:
Linkedin

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

Linkedin

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

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

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

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

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

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

What drew you to this project?

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

What was one of the most interesting findings?

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

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

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

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

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

Other places to connect:
Website