Book Releases: New Texts on Sex Tourism, Biotechnology

This week, we are featuring two book releases from the University of Chicago Press. The first book is Gregory Mitchell’s Tourist Attractions: Performing Race and Masculinity in Brazil’s Sexual EconomyThis new book, published in December 2015, presents an ethnographic perspective on gay sex tourism in Rio de Janeiro, Salvador de Bahia, and the Amazon. Mitchell examines issues of race, masculinity, and sexual identity amongst both sex workers and sex tourists. In particular, he asks how men of various racial, cultural, and national backgrounds come to understand their own identities and one another’s within this complex series of commercial, sexual, and cultural exchanges. Details about the book can be found here.

About the author: Gregory Mitchell is assistant professor at Williams College, where he teaches in the Women’s, Gender and Sexuality Studies program and in the Department of Anthropology and Sociology.

9780226309101

Image via UC Press website

The second book, debuting in September 2016, is Hallam Stevens’ Biotechnology and Society: An Introduction (cover image not yet available.) Each chapter of the text will address a different topic in the cultural and historical study of biotechnology, from gene patents, to genetically-modified foods, to genetic testing and disability, assisted reproductive technologies (ARTs), and the intersections of race, diversity, and biotechnologies. The text will be of equal interest to scholars of science and technology studies (STS), posthuman theory, and the history and culture of medical technology. Details about the book can be found here.

About the author: Hallam Stevens is assistant professor at Nanyang Technological University in Singapore. He teaches courses in the history of the life sciences and information technologies. He is the author of Life Out of Sequence: A Data-Driven History of Bioinformatics, also available here via the University of Chicago Press.

 

Issue Highlight: Vol 39 Issue 4, Stimulant Use in the University

This blog post is the last in a three-part series highlighting our newest installment of Culture, Medicine & Psychiatry (released December 2015) which readers can access here. This week, we explore Petersen, Nørgaard, and Traulsen’s research on the use of prescription stimulants amongst university students in New York City. The full article is available here.


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In recent dialogues on the widespread use of prescription stimulants amongst university students, drugs are often described as enhancing productivity or a student’s ability to successfully focus on academic work. However, Petersen, Nørgaard, and Traulsen found that university students in New York City often cited the use of these drugs as rendering their work more pleasurable, “fun,” and “rewarding.” Their study included 20 students spanning BA, MA, and PhD programs: representing a diverse sample that, in the aggregate, universally suggested that the use of stimulants in an educational setting was not centrally connected to academic output or production. This outcome, the researchers assert, complicates existing neoliberal readings of American personhood, premised on the idea that the self is primarily cultivated and disciplined through labor and individual productivity.

For example, rather than feeling shameful about using stimulants to improve study skills or produce better work, the students instead expressed guilt for enjoying their academic labors and for transforming “monotonous” and “boring” activities into an engaging experience. The “optimization” of the mind to perform intensive intellectual labor was not related strictly to productivity, which would evoke traditional neoliberal notions of the person-as-producer. Instead, the students described the drugs as optimizing pleasure first, which rendered them more productive as a secondary consequence.

Take this instance: a 32-year old PhD student, identified as Ben, reported using Adderall when he felt too “lazy” to initiate work. Rather than continuing by discussing the extent of his productivity while on the drug, he instead explains that the drug makes him eager “to tackle” his projects. This is often the case for students who struggle to find the desire to complete academic tasks that are not interesting enough to begin without being made pleasurable through stimulant use. Further, another student added that using stimulants helped him to “reconnect” with his interest in sociology during a difficult class on social science theory. In other cases, using Adderall kept students from being distracted from social media or entertainment websites: not because they lacked the inherent ability to be productive, but because without the drug, these sources of interest were simply more engaging than the work at hand. In other instances, students noted that stimulants made them feel more secure and positive about the quality of their work, and helped them to diminish the physical and mental stresses that came with “all-nighters,” or extended overnight studying stints.

Throughout all these cases, enhancement is not described as a means to make the human brain meet the demands of a “high-speed society.” Instead, “enhancement” relates to students’ satisfaction with their resulting work, to their enjoyment of otherwise “boring” tasks, and to reduced the negative psychosomatic effects of studying or working on a limited time frame.

The authors do not eschew the neoliberal model through these cases: indeed, they suggest that the use of stimulants does have cognitive effects that bolster students’ abilities to produce academic work. However, they note that we must complicate a strictly neoliberal model that would indicate that stimulants are employed by students strictly in order to achieve a certain amount of studying or to complete an assigned amount of work. Enhancement may include productivity, but for students who use stimulant drugs, it also involves increasing the pleasure of finishing intellectual labors, and decreasing the negative consequences of engaging in challenging or otherwise tedious academic work.

In this way, cognitive-enhancing drugs indeed fortify the mind and the conception of the self as a producer and academic laborer. However, they also shape human experience by altering students’ sense of confidence, their satisfaction with academic work, and their passion for their chosen topics of study. In these ways, enhancement drugs not only increase productivity in the neoliberal sense: they also broadly impact notions of pleasure and individual ability related to students’ quest to heighten academic production.

 

 

Issue Highlight: Vol 39 Issue 4, Posthumous Reproduction

Our final issue of the year– Volume 39 Issue 4 December 2015– has just arrived. In our last blog post series for 2015, we begin with a three-part feature of the latest publications at the journal in this new issue. In addition to the article previews in this series, our readers can access the full issue here. In this post, we explore Yael Hashiloni-Dolev’s preliminary research on posthumous reproduction in Israel (full article accessible here.)


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Biomedicine, through its innovative application of technology, can reconfigure biological experiences in ways that alter or reinforce cultural beliefs surrounding life, death, reproduction, kinship, parenthood, and social roles. Most recently, this has become a central issue in the field of assisted reproductive technologies: where biomedical interventions potentiate new relationships between parents, families, and children. But while assisted reproductive medicine is often discussed in terms of generating life, these new generative technologies may also intersect with death in novel ways that challenge existing understandings of kinship and familial relationships.

Hashiloni-Dolev article studies Israeli lay perceptions of a new concept in assisted reproductive medicine called posthumous reproduction (PHR.) In sum, PHR entails the use of genetic material from deceased parents to conceive children after their deaths. This usually means a woman will opt to become artificially inseminated with a husband or partner’s sperm retrieved while the man was in a coma or vegetative state: however, it may also include the fertilization of a woman’s eggs, frozen while she was alive, and gestated in a surrogate mother. Even frozen embryos of two deceased parents (a mother and father) might be “adopted” and implanted into a female relative or another recipient, who subsequently gives birth to a child whose biological parents are no longer alive. This process also facilitates the possibility of posthumous grandparenthood, and indeed, some parents whose adult children have died may seek out PHR technologies (include allied technologies such as surrogacy) to produce grandchildren.

Israel is one of the few countries that permits some forms of PHR, and it is a progressive nation in terms of reproductive technologies: its state health system covers the costs of ARTs (assisted reproductive technologies) for couples who have difficulty conceiving. Although Israel does not permit all forms of PHR, it does allow for the collection of a man’s sperm upon a wife’s request to carry his child upon his death (what the author calls the “prototype scenario.”) In this regard, Israel served as a prime location for surveying participants and testing initial ideas about the public perception of PHR: a new frontier of ARTs yet to be studied in the anthropological literature.

Through 26 semi-structured interviews with newlywed or childless couples, Hashiloni-Dolev discovered that there were some inconsistencies between the Israeli PHR policies and the participants’ understanding of PHR technologies. For instance, the government stipulated that PHR could occur via the retrieval of sperm from a dying or recently deceased father upon the wife or female partner’s instruction. The policy states that the retrieval could occur given evidence of a man’s “presumed wish” that he would want his spouse or partner to carry his child after death. However, “wish” and “consent” were interpreted differently by men interviewed for the study. The men typically stated that while they would defer to their partner’s wishes to have a child after their death, they themselves were uncomfortable with the possibility of their partners having the child and being unable to “move on” should they pass away. In this instance, while the man’s presumed “wish” might not change a woman’s decision to retrieve his sperm posthumously, it does not mean the man would “consent” to the process if he were not already dead.

Conversely, consent becomes more complicated given the circumstances that typically surround the use of PHR. The man is presumably young, such that his female partner would be able to carry his child, and would have died suddenly: thus making it nearly impossible to obtain his consent unless he had already affirmatively offered it while still alive and healthy.

There were also issues related to the family life of a child born through PHR techniques. Both male and female participants worried about the emotional stability and security of children born out of such conditions, and expressed their concern with new policies being proposed that would allow for expanded posthumous grandparenthood rights. The participants believed that the decision to have children following the death of a spouse was between the couple, and was not between other family members. Likewise, many participants worried about the birth of a child as a living shrine to the deceased, rather than as a new and autonomous member of the family.

In these responses, it is clear that while both biomedical technologies and governmental policies may enable PHR to occur, the process is not always viewed in such liberal terms by individuals who could be most likely to use it. Posthumous reproduction thus supplies medical anthropologists and scholars of social medicine with a nuanced case of the cultural position of new technologies, and the concerns that individuals across cultures have with these new reproductive tools: particularly as they relate to consent, kinship, and the roles of parents.

 

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.

AAA 2015 Sessions: Food Sovereignty and Food Economies

Last Fall 2014, we featured a series of blog entries highlighting sessions at the AAA 2014 Annual Meeting on topics of interest to our readers. This year, we feature sessions from this year’s AAA 2015 Annual Meeting, to be held November 18-22 in Denver, Colorado (more information here.) You can also browse another past installment of the blog, where we highlighted sessions on biomedicine and the body at the upcoming Society for Social Studies of Science (4S) meeting, also in Denver, to be held November 11-14 (details here.)

This week, we present three paper sessions on anthropological approaches to food sovereignty and food economies: topics that have been increasingly of interest to medical anthropologists who study related issues such as body image, preventative care, nutrition, and well-being. The sessions are organized chronologically by date.

Image via AAA Website

Image via AAA Website

Food Values in Europe: Sustainable Economies, Power, and Activism

Thursday, November 19th 8:00am-9:45am (details here.)

Topics in this session will include the decommodification of food and organic food supplies; organic food provisioning in Catalonia; food values amongst British-born African Caribbean peoples in the United Kingdom; food waste and recycling in southern Spain; food politics, communities, and the garden in the Czech Republic; sustainability in a Galician dairy farm; and food ideologies in an urban Portuguese garden. The session crosses numerous topics of study including European cultures, sustainability and the environment, cross-cultural food practices, green space and the role of the garden, and global nutrition.

Critical Perspectives on Food Sovereignty, Food Justice, and Food Citizenship

Friday, November 20th 1:45pm-3:30pm (details here.)

This session will include presentations on the following topics: agricultural activism in Cuba; food access amongst migrant farm laborers; food justice at the border of the United States and Mexico; food sovereignty in Mexico in popular narratives; food literacy amongst women in a food-insecure neighborhood; and an analysis of divergent perspectives on food justice. These papers will offer valuable perspectives on the role of food in disparities across economic classes and across national borders.

New Directions in Agriculture and Culture: The Convergences of Food, Labor, and Neoliberalism

Saturday, November 21st 8:00am-9:45am (details here.)

Presenters in this session will address: a case study in sustainable entrepreneurship; food sovereignty and food landscapes in Detroit, Michigan; labor and food in a Wisconsin farm-to-table network; Haitian farmers and socioeconomic change; technoscience, translation, and olive oil; seeds and labor on the shorelines of Turkey; and an ecological study of resistance and labor on a South African plantation. These sessions will appeal to scholars who work on economic anthropology, nutrition, or political ecology.

4S 2015: Sessions on Biomedicine, the Body, and Knowledge

Last year, we featured blog posts that highlighted paper sessions on various topics in medical anthropology and social medicine presented at the annual AAA (American Anthropological Association) meeting in Washington, DC. This year, we are heralding in conference season by featuring details on two upcoming events: the AAA meeting and the annual meeting of the Society for Social Studies of Science (4S). Both conferences will be held in November 2015 in Denver, CO. You can find out more about the AAA Meeting here (http://www.aaanet.org/meetings/) and the 4S Meeting here (http://www.4sonline.org/meeting.)

Logo of 4S via the organization's website

Logo of 4S via the organization’s website

The 4S organization brings together researchers whose works span all aspects of scientific research, production, and the impact of science on society. Despite the organization’s breadth of represented interests, many scholars of social medicine take a science and technology studies (STS) approach and are active in 4S. This week, we highlight sessions at the 4S Meeting that emphasize their research and paper sessions on biomedicine. Sessions are organized chronologically by date and time.


Sex and Gender in Biomedicine

Thursday, November 12th 8:30-10:00am

Click here for details on this session.

This session will feature three presentations on sex and gender in biomedicine focused on the following topics: cosmetic surgery in South Korea and the United States, the history of biological sex as defined by the sciences, and the role of a parasite transmitted through sex on the reproductive lives of humans. The papers propose new understandings of sex and gender as constructed through scientific knowledge and practice.

Examining the Exceptional: Case Studies of Knowledge Production in Biomedicine and Science

Thursday, November 12th 10:30am-12:00pm

Click here for details on this session.

Topics in this session will address: microevolution and genetic science on indigenous men in Brazil; the definition of crisis in emergency medicine in the United States; sickle cell patient advocacy in Brazil; a comparative case of pregnancy monitoring in the USA and the United Kingdom; and immigrant physicians and medical professionals arriving in the United States as an “exceptional” population. These papers will offer various examples of the way that science constructs meaning for patients and practitioners of biomedicine alike.

Biomedicine and Difference

Thursday, November 12th 2:00-3:30pm

Click here for details on this session.

In this session, presenters will explore: human microbiome research; astronauts, race, and physical preparation for conditions in outer space; representations of race in a stroke awareness campaign; past technologies for measuring skin color; and the breakdown of ethnic origin by genetic percentages. These papers will scrutinize the complex and often problematic relationships between race, science, medicine, and the body.

The Body in Biomedical Knowledge

Friday, November 13th 4:00-5:30pm

Click here for details on this session.

This session will address the following topics: food insecurity, the use of inmates as test subjects, obesity, and anatomical and physiological representations in 20th century Chinese medicine. The session will also feature the work of our blog editor, Julia Knopes, on the ontological status of cadavers as objects in Western medical traditions.

Replaceable Parts: Prosthetic Technologies in Biomedicine 

Saturday, November 14th 10:30am-12:00pm

Click here for details on this session.

Presenters in this session will speak about new surgical robots, the role of prosthetic limbs amongst wounded military veterans, cross-cultural readings of prosthetic making in Canada and Uganda, 3D organ printing and facial transplants, and the experiences of amputees in an ever-changing landscape of prosthetic and bionic technologies. The sessions in this paper panel will offer fresh perspectives on the meaning of the cyborg, a continued area of interest for many medical anthropologists and researchers in social medicine.

News: UN Releases New Sustainable Development Goals (SDGs)

On Friday, September 25th, the UN released its new plan for global development through 2030: the sustainable development goals (SDGs).[i] This plan replaces the millennium development goal (MDG) plan that expires at the end of 2015, and offers a new 17-point agenda focused on social equality, infrastructure, technology, and environmental conservation.[ii] Of note to medical anthropologists, global health workers, and other scholars in social medicine is the continued focus on health and well being as the third item amidst the seventeen goals. The SDG plan champions health “for all at all ages,” although it proposes no specific goals for improving elder care despite the language stressing health across ages. Maternal and reproductive health, substance abuse, traffic deaths, and universal health care coverage are key issues addressed in the SDGs.

Emblem of the UN via Wikimedia Commons

Emblem of the UN via Wikimedia Commons

Proponents of the new SDGs, like the World Bank, argue that the plan’s emphasis on both developed and developing countries creates a shared impetus for bolstering food security, education, and access to quality health care; likewise, it suggests that these issues are global ones that cross national borders, and do not exist at the state level alone.[iii] Others criticize the SDGs as too ambitious, arguing that global authorities already struggle to aid migrants and peoples in crisis[iv], stating that the goals are too broad and thus not focused enough to produce observable change[v], and highlighting the irony of combating climate change while promising electricity for all by 2030.[vi]

Anthropologists have long held an interest in international development as a site of cross-cultural exchange, a relic of colonialism, and as a paternalistic model of societal shepherding of developing nations by the wealthy West and Global North.[vii] Amongst development anthropologists, the sustainable development goals will certainly generate new questions about the connectedness of social inequities with health, autonomy, and human rights in the contemporary age. The goals will similarly continue to attract the interest of scholars studying biomedicine and global health in diverse cultural settings.

In addition, the SDGs will no doubt capture the attention of anthropologists in science and technology studies (STS) with the plan’s robust emphasis on technologies, energy, infrastructure, and the environment. This sharpened focus on the connection between social order, science, and technology attests to the applicability of STS approaches to the study of development.

The SDGs arrive at a time of increased concern over social justice and equity on the transnational scale, particularly in the face of the Syrian refugee crisis[viii] and given wide income gaps that impact people in the United States, Chile, Greece, Mexico, and Turkey alike.[ix] Anthropologists are ideally situated to explore the impact of development goals across cultures, and to question how and why these goals may face considerable challenges as they are translated into action, law, and practice at the local level.


[i] http://www.theguardian.com/global-development/2015/sep/25/global-goals-summit-2015-new-york-un-pope-shakira-malala-yousafzai

[ii] https://sustainabledevelopment.un.org/topics

[iii] https://blogs.worldbank.org/voices/global-goals-economic-transformation-in-an-interconnected-world

[iv] http://www.npr.org/sections/goatsandsoda/2015/09/28/444188463/are-the-new-u-n-global-goals-too-ambitious

[v] http://www.scientificamerican.com/article/sustainable-development-goals-offer-something-for-everyone-and-will-not-work/

[vi] http://www.theatlantic.com/international/archive/2015/09/energy-access-sdgs-un-climate-change/407734/

[vii] http://www.wiley.com/WileyCDA/WileyTitle/productCd-0631228802.html

[viii] http://www.cnn.com/2015/09/28/world/united-nations-main/

[ix] http://www.reuters.com/article/2015/09/27/us-development-goals-challenges-analysis-idUSKCN0RR0TV20150927

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, Suicide in Rural Kenya

When a new issue of Culture, Medicine & Psychiatry is released, we feature a series of blog posts that highlight these latest publications in our journal. The current September issue includes articles that address psychiatric conditions and the experiences of people with mental illness across cultures. Readers may access the full issue at Springer here: http://link.springer.com/journal/11013/39/3/page/1. In this issue highlight, we will discuss an article on ethnographic analyses of suicide and distress amongst three communities in northern Kenya.


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Suicide in Three East African Pastoralist Communities and the Role of Researcher Outsiders for Positive Transformation: A Case Study

Bilinda Straight, Ivy Pike, Charles Hilton, and Matthias Oesterle – Pages 557-578

http://link.springer.com/article/10.1007/s11013-014-9417-4

The authors of this article strive to establish a nuanced and ethnographically rich understanding of suicide and mental distress in an under-studied population of three distinct, yet interacting, pastoral communities in northern central Kenya. These three groups– the Pokot, Samburu, and Turkana– are engaged in intercommunity conflicts over territory and land use agreements, despite the communities’ shared and entangled oral histories. Such tensions are only exacerbated by mutual fear of raids by other groups, dearths in food available for forage, and the theft of livestock from individuals who sell the animals to finance political campaigns. Poverty is likewise aggravated by these patterns of loss and violence.

This turbulent social environment creates widespread mental distress amongst the three communities, yet individuals from each group stressed to the research team that they felt obligated to persevere despite these pressures, making admitting psychological suffering (and especially confessing thoughts about suicide) deeply taboo. Therefore, any mental health intervention would have to be responsive to the extent to which Pokot, Samburu, and Turkana culture disallow individuals from discussing or even thinking about suicide: an act which could create even more social strain on the family of the person who committed it. The researchers confirmed this inability to discuss suicide by the high rates of non-response on a survey question which asked participants whether or not they had experienced suicidal thoughts.

Suicide thus proves to be a unique case for anthropological analysis because it is both driven by the social conditions of those who take their own lives, as well as disruptive to the communities in which these people lived. Its treatment by global health workers must in turn be sensitive to cultural beliefs that forbid conversation about suicide, especially in communities where the death of an individual may contribute to already extraordinary social distress.

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.