From the Archive: “On the Social Constructionist Approach to Traumatized Selves in Post-disaster Settings: State-Induced Violence in Nandigram, India”

This week we are highlighting an article from September 2015 (Vol. 39, Issue 3) entitled On the Social Constructionist Approach to Traumatized Selves in Post-disaster Settings: State-Induced Violence in Nandigram, India by Kumar Ravi Priya. The article discusses how a social-constructionist analysis into exploring how the continuity of self-hood is threatened or altered within socio-political and cultural contexts generates the experiences of suffering and healing. Through an ethnographic study conducted among the survivors of political violence in Nandigram, India, Dr. Priya aims to study the experiences of suffering and healing among the traumatized selves.

Priya states that the distressing experiences of survivors are understood in psychology and psychiatry principally as the behavioral symptoms resulting from an “incomplete emotional and cognitive processing of traumatic events.” With such an exclusive focus on the intra-psychic processes, trauma-related distress associated with the cultural interpretation of loss is largely ignored. Through an ethnographic study among the poor farmers of Nandigram, India, subjected to violence from the state government as it tried to forcibly acquire their land, Priya discusses the utility of the social constructionist paradigm in understanding the survivors’ experiences of suffering and healing within the cultural and sociopolitical context of violence.

Multidisciplinary approaches to subjective experiences of trauma state that a complete focus on posttraumatic stress disorder (PTSD) may be ontologically irrelevant in cultures that do not value the notions of an individualistic self. Priya states that unlike the positivist tradition of research within mainstream psychology and psychiatry, the social-constructionist paradigm opens up the scope for psychological understanding of human experiences in their sociocultural and historical contexts. Alternative conceptualizations of the psychological impact of trauma must incorporate the cultural notions of self and how its coherence is threatened and re-negotiated amidst the traumatic events and their sociopolitical consequences.

For Priya, people can suffer from what they have lost of themselves in relation to the world of objects, events, and relationships. Such suffering occurs because an intactness of person, a coherence and integrity, comes not only from intactness of the body, but also from the wholeness of the web of relationships with self and others. The wholeness that a person experiences may be threatened if they not able to uphold the culturally valued aspects of self-definition. Yet it is the social world, even when mutilated in war or violent events, that holds the key to recovery or healing. Healing can be described as the process of restoring the experience of wholeness by reformulating aspects of person in a new way.

Priya uses themes of suffering and healing to highlight how the traumatized selves experience intense distress resulting from disruptions to a sense of wholeness. Yet this wholeness may also be reformulated through culturally valued beliefs. Themes include “experience of PTSD symptoms,” “betrayed self,” “overwhelmed by loss,” “biographical disruption,” “moral reaffirmation,” “sense of togetherness,” and “sense of security due to change in political environment.”

Aman, a 36-year-old man who worked as a daily-wage laborer, lost his teenage son in an attack on a political demonstration he was participating in. Aman’s account often reflected his distress due to sorrow and grief, as well as his inability to comfort his inconsolable wife. “At 12 midnight or 1 a.m., I am reminded of my [deceased] child, I start crying. I do not know when I fall asleep while crying.”

In the case of Aman, such an experience of loss of relationship may have an overpowering or overwhelming impact. This impact may render the past and immediate future difficult to be comprehended by the survivors. In Priya’s analysis, despite being overwhelmed, Aman also shared a sense of fulfilment over the martyrdom of his son. He also shared a new enabling meaning in life through culturally valued beliefs of taking care of one’s family.

For Priya, a social-constructionist analysis into exploring how trauma in post-disaster settings affects the continuity of selfhood goes beyond the traditional psychological PTSD diagnosis and generates the experiences of suffering and healing.

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AAA 2015 Sessions: Medical and Patient Bodies

This entry is our last in a three-part blog series on the upcoming American Anthropological Association (2015) meeting, to be held in Denver, CO from November 18th-22nd. Here we feature paper sessions on contemporary themes in medical anthropology and social medicine. This year, we showcased sessions on the anthropology of mental health care (read here) and on cultural approaches to food sovereignty and economies, featured last week. In this installment, we highlight three sessions on the theme of the medical and patient body. All sessions are listed chronologically by date and time.

Image via AAA Website

Image via AAA Website

The Politics of Health and Ritual Practices: Ethnographic Perspectives

Wednesday, November 18th from 2:00pm-3:45pm (details here.)

In this session, topics will include: health and religion in Putin’s Russia; rhetoric and biopolitics in local medicines of North India; hypochondria, somatic experience, and psychiatry in Soviet-era Bulgaria; and the implications of mortuary rituals in neoliberal Romania. These papers will particularly interest scholars who study the relationship between body and state, as well as those who examine the intersection of religion, health, and healing practice.

The Biosociocultural Trajectory of Stigma

Sunday, November 22nd from 10:15am-12:00pm (details here.)

Papers in the session will address stigma in the following contexts: methadone treatment in a Moldovan prison; HIV+ identities in intergenerational perspective; changes in HIV/AIDS stigma in Western Kenya; stigma and HIV/AIDS as chronic versus curable; obesity and depression in Puerto Rico; and de-stigmatization in massive weight loss. Through these presentations, the session will posit the medical body at the center of social discourses on stigma, illness, and treatment across cultures.

Micropolitics of Medical Life

Sunday, November 22nd from 10:15am-12:00pm (details here.)

This session spans topics such as: organ donation and the family in Japan; patient-centered approaches to biomedical readmission; infant health in El Salvador; translation and language in medical encounters; ethnographic research on contaminated water exposure and local treatments for infant diarrhea; dialysis and the family unit; and the connections between cells, culture, and knowledge-making. These papers will underscore the cross-cultural ties between body, biology, illness, culture, and daily life.

Book Release: “The Law of Possession: Ritual, Healing, and the Secular State”

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Image via Oxford UP website

Out this November 2015 from Oxford University Press is an edited collection by William S. Sax and Helene Basu entitled The Law of Possession: Ritual, Healing, and the Secular State. The text presents both contemporary and historical case studies of the relationship between spiritual conflict and judicial exchanges across cultures. While rituals to exorcise spirits from the afflicted are typically characterized solely as acts of healing, they are also scenarios in which spirit healers do justice by the possessed by driving out a spirit who has committed an act of evil against the person they inhabit. Spirit possession may similarly provide valuable opportunities for members of a community to contact restless spirits through a human oracle. These otherworldly entities may then offer evidence to the living as to how to avenge or appease them, thereby restoring social harmony. Healing, justice, cosmic order, and religion are thus closely integrated within these culturally meaningful negotiations.

The authors of the text challenge the assumption that these spiritual encounters– which have consequences for both medicine and the law in many societies– are antiquated and do not belong in modern societies or in secular governments. By drawing on examples from East Asia, South Asia, and Africa, the authors assert that spiritual healing and law nevertheless persist in the contemporary age as a way to meet social and religious needs in many cultures.

Learn more about the book (in paperback) by clicking here.

Link to the hardcover copy: https://global.oup.com/academic/product/the-law-of-possession-9780190275747?cc=us&lang=en

About the editors: William Sax teaches at the University of Heidelberg, where he serves as the Chair of Cultural Anthropology at the South Asia Institute. Helene Basu is the director of the Institute of Social Anthropology at Münster University.

Issue Highlight: Vol 39 Issue 3, Maya Mental Disorders in Belize

With each new issue of Culture, Medicine & Psychiatry, we feature a series of blog posts that highlight the latest publications in our journal. This September’s issue includes articles that address psychiatric conditions and the experiences of people with mental illness across numerous cultures. Readers may access the full issue at Springer here: http://link.springer.com/journal/11013/39/3/page/1. In today’s issue highlight, we will examine a study on indigenous nosologies of mental illness amongst the Maya of Belize.


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Narrative Structures of Maya Mental Disorders

Andrew R. Hatala, James B. Waldram, and Tomas Caal – Pages 449-486

http://link.springer.com/article/10.1007/s11013-015-9436-9

To understand the compatibility of divergent medical traditions, it is first essential to describe how medical systems classify and interpret disorders in particular ways. With this aim in mind, the authors of this ethnographic study sought to develop an picture of indigenous mental illness nosology amongst the Q’eqchi’ Maya of southern Belize. They also asked how this knowledge may alternatively coexist, or compete, with biomedical concepts of suffering.

In order to learn about this indigenous medical epistemology, the authors worked with the Maya Healers’ Association, a professional, self-regulated group of twelve healers who maintain a garden of medicinal plants for research and who strive to reinvigorate traditional medical practice in Belize. Across ninety-four interviews with healers, the authors uncovered four illness categories that the participants used to describe the roots of mental illnesses: “thinking too much,” fright, the day of birth, and spirit “attacks.”

These descriptions are sometimes cross-compatible with DSM-V nosologies, as the researchers discovered that “thinking too much” was also listed as a symptom in biomedical models of mental illness. However, unlike the DSM-V, Maya healers tended to characterize overthinking as a “genre” of illness experience rather than as a discrete symptom. Maya healers also characterize mental illnesses as existing within the heart, the mind, and the spirit: thereby expanding the implications of mental illness beyond brain physiology, the proximate explanation employed by biomedical psychiatry.

The authors conclude that it is essential to understand the similarities in the two nosologies to facilitate collaboration between indigenous and biomedical healers, but add that both groups must also be aware of the differences in classificatory schemes that they use to interpret mental illness. In this way, people with mental disorders in Belize may best receive care that accounts for all of the ways they might seek care and understand their illness across the boundaries of medical systems.

From the Archive: Witchcraft and Healing in the Colonial Andes, 16th-17th Centuries

In our “From the Archive” series, we revisit articles published throughout the journal’s history, and explore the meaning of these publications for contemporary issues in medical anthropology, medical humanities, and social medicine. This week, we explore Irene Silverblatt’s December 1983 article “The evolution of witchcraft and the meaning of healing in colonial Andean society.”cropped-cropped-2009cover-copy1.jpg

Silverblatt writes that while the Spanish conquistadors were laying claim to land and peoples in South America in the 16th and 17th centuries, their countrymen in Spain were in the throes of the Spanish Inquisition. Traditional healers (most often women) were tortured and killed as agents of the devil. These healers were assumed to either mask deadly curses in the form of cures, or to have received their healing knowledge from a diabolical pact. Rather than leaving this battle against traditional healing at home in Europe, the Spanish conquistadors carried the legacy of the Inquisition with them across the world, imposing similar religious restrictions on traditional healers in the societies they conquered by holding Inquisition-style court hearings.

European cosmologies, based intensely on the dualistic struggle between good and evil, did not evenly graft onto the Andean worldview. In the Peruvian Andes, where Silverblatt focuses her paper, women were not considered morally inferior to men and more susceptible to evil; likewise, native Andean models of disease viewed illness as the result of an imbalance between the individual, society, and supernatural forces, rather than caused directly by evil spirits. Andean healers thus served as both priests (who placated the spirits to seek balance in the universe) and as healers (who treated the individual sufferer with herbs or medicines.) Their treatments relied on the connectedness between the community, spirits, and the healers themselves.

Yet throughout the 16th century, in the period of Spanish colonization, exposure to Christian mythology and cosmology led these healers to view their practice differently. By the 17th century, Andean healers tried by Spanish inquisitors confessed to dreams and visions wherein they received recipes for herbal medicines from the spirits. The devil in these accounts, though, took on particular forms: that of the Christian saint Santiago (the patron of Spain), as tiny angels (also Christian entities), men dressed in cloaks, or as snakes. The latter proved the closest form of Satan to appear in the Spanish religious canon, but these spirits were scarcely the hideous, bestial demons known to Spanish lore. Indeed, Silverblatt posits that the healers envisioned Saint Santiago as their spiritual contact because they fashioned him as another form of the Thunder God, a native figure representing conquest who could also ward off diseases caused by sorcery.

Throughout the primary legal documents that Silverblatt reviews, the healers also argued that the spirits– even when described as malignant– served them equally to help and to cause harm. The spirits were not agents of evil alone in their stories. These confessions suggest that the Andean relationship to spirits in the Christian narrative remained connected to their native ideology of cosmological balance and harmony, wherein the spirits could be responsible for imbalance or harmony. In this fashion, traditional healers on trial resisted traditional Spanish notions of devil-worship, while simultaneously asserting the validity of their own indigenous notions of spiritual and social balance within healing.

Silverblatt’s piece contains a valuable lesson for continued inquiry into colonialism and neocolonialism. She invites us to analyze colonization as a dialectical relationship between colonizers and the colonized, and consider the way that the tensions between these two populations’ ideologies come to create novel cosmologies, beliefs, and perspectives. Likewise, she suggests that the authority of a medical system is tightly woven into the social and political worlds in which it is practiced. Silverblatt similarly concludes that rather than reading colonial threats towards indigenous medicines as hegemonic, we discover much more by locating the resistance of native healers to newly-introduced ideas about healing, and by analyzing the ways that they integrate foreign beliefs into their outlook on medical practice.


To access the full article through Springer, click here: http://link.springer.com/article/10.1007/BF00052240