Interview With Domonkos Sik

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

Associate Professor, Eötvös Loránd University, Budapest

My research deals with various topics in critical theory including political culture and mental disorders in late modernity. My work has appeared in such venues as The Sociological Review, Theory, Culture & Society, European Journal of Social Theory, Thesis Eleven, Journal of Mental Health. Most recent books: Empty suffering (Routledge 2021) Salvaging modernity (Brill 2025).

What is your article “Between Depression and Alienation: Burnout as a Translator Category for Critical Theories“ about?

The article explores the psychopathological and sociological discourses surrounding the contested notion of burnout, with the aim of reintroducing it as a ‘translator category’. Such concepts, which can translate between everyday language, medical language and critical language, are particularly important in cases which originate from both individual and social causes. Without these translator categories, biomedical and psychopathological interpretations veil the social components of suffering – therefore, inevitably mistreat it as an exclusively individual problem. Furthermore, attempts at social critique also remain inaccessible because they rely on their own set of diagnostic concepts (such as alienation), while lay actors interpret their suffering as an illness or mental disorder (such as depression). To avoid these dead ends, the article discusses how burnout as a translator category can link the discourses of alienation (as a cause of burnout) and depression (as a consequence of burnout) while remaining accessible as a lay category.

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

I was trained as a sociologist and philosopher in post-socialist Hungary. Initially, my research focused on democratic transition, particularly its phenomenological features. Since 2010, however, my attention has shifted from the criteria of democratic culture to the personal consequences of failed democratization. This led me to explore the links between social suffering and mental health issues, a topic which has become my main area of expertise over the last decade.

What drew you to this project?

After exploring several clinical categories (e.g. depression, anxiety, addiction) from a critical theoretical-phenomenological perspective (see my book Empty Suffering) I became interested in a phenomenon located at the intersection of biomedical and lay discourses. This is how I found the topic of burnout, which is contested within the biomedical discourses, while being widely applied by the lay actors at the same time.

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

I enjoy reading novels, viewing them not just as an excellent way to relax, but also as a constant source of inspiration for my social scientific work. As well as the better-known classics by authors such as Balzac and Dostoevsky, and contemporaries such as Ali Smith and Kazuo Ishiguro, I also enjoy the vivid Central European literary scene (authors such as Péter Nádas and Mircea Cărtărescu).

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

Most mental health conditions are inextricably linked to social dysfunction and structural distortion. If we do not address the ‘social pathologies of contemporary civilization’ (that is also the name of a research network I am currently involved in: https://socialpath.org/), there is little hope of stopping the ‘epidemics’ of depression and burnout.

Other places to connect:

Website

Interview With Florin Cristea

Posted by michellezernick

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

Florin Cristea is a PhD candidate in psychological and medical anthropology at the Freie Universität Berlin. His research focuses on understanding the moral world of people diagnosed with severe psychiatric disorders. In his work, he engaged with the social and clinical life worlds of people with a lived experience of psychiatric encounters in Romania, Tanzania, and Indonesia.

What is your article “Navigating the Unknown: Mental Pain, Uncertainty, and Self-Isolation in Bali and Java“ about?

Suffering has long been a central theme in anthropology. Yet, despite growing interest in psychology and psychiatry, anthropological engagement with mental or emotional pain (as stand-alone concepts) has remained limited. In my article, based on fieldwork in Indonesia on severe psychiatric disorders, I tried to understand the impact of mental pain on the person experiencing it and their immediate environment. I first outlined the salient attributes of mental pain as they emerged during my conversations with patients and observations of their everyday lives. I then suggested that these attributes contributed to the uncertainties individuals faced as part of their experiences with severe psychiatric disorders. Finally, my main argument was that the interplay between mental pain and uncertainties informed certain illness behaviors, particularly tendencies toward self-isolation.

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

I am interested in the anthropology of mental health and illness, as well as in Global Health and Global Mental Health. I am fascinated by how different knowledge worlds come together and influence people’s understanding of what it means to be healthy, sick, and ultimately human. While my work has been strongly influenced by critical medical and psychological anthropology, I try to maintain an open engagement with the psy and biomedical sciences and seek venues of mutual understanding and collaboration.

What drew you to this project?

I initially was drawn to alternative understandings of the mind in Indonesia. However, mapping out these understandings proved far more complex than I had anticipated. Addressing mental pain was my way of making sense of the muddle that became my data.

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

A friend recently recommended “Lightseekers” by Femi Kayode, and I am looking forward to reading it on my upcoming vacation. I am grateful to have time to enjoy something completely unrelated to work.

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

Isolation of people diagnosed with a severe psychiatric disorder is a fairly common problem, irrespective of where it occurs. It is important to note or to reiterate that isolation is not only the result of social attitudes toward mental illnesses, nor is it an individual issue. It is part and parcel of the intersubjective nature of the encounter between the social and the individual. We need to do better in understanding this relationship.

Other places to connect:

Interview With Henry J. Whittle

Posted by matthewbmartinelli

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

Doctoral researcher, Department of Anthropology and Sociology & Centre for Anthropology and Mental Health Research in Action (CAMHRA), SOAS University of London

Dr Henry Whittle is a psychiatrist and anthropologist in training. He began his research career using mixed methods to study food insecurity, before pivoting towards mental health rehabilitation after specialising in psychiatry. Following further training in medical anthropology, he is currently working towards a PhD at SOAS University of London.

What is your article “Ronaldo on the Clapham Omnibus: Complex Recoveries in Complex Psychosis“ about?

In the article, I think about what we mean by recovery in psychosis. I ask how it complicates our current understanding of recovery if we consider the experiences of people with the most complex forms of psychosis. These people are inadvertently excluded from much debate on this topic. Ethnography is one of the few ways that their experiences can be incorporated meaningfully. Drawing on six months of ethnography on an inpatient psychiatric rehabilitation unit, the article centres around a man I call Shepherd, whose journey to becoming a more confident, calmer, happier person looked very different to most portraits of recovery in the existing literature. This is important because our understanding of recovery shapes mental health policy in material ways. If we oversimplify recovery by missing people like Shepherd, we risk structurally undermining the interventions—including inpatient rehabilitation—that may be most effective in supporting them to live well.

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

I am a psychiatrist and anthropologist, still working through my training in both disciplines. I currently work in an Early Intervention in Psychosis service in London and I will be part of the new Centre for Anthropology and Mental Health Research in Action (CAMHRA) at SOAS University of London. My research interests broadly relate to the social, cultural, and structural influences on mental health care and recovery, particularly for people living with more severe and enduring mental illnesses. Above all, I am an advocate for using applied social science as a basis for dialogue with service users, clinicians, practitioners, relatives, carers, and everyone else invested in improving mental health services.

What drew you to this project?

I have been intrigued by inpatient units ever since I first started working in psychiatry. Even though things are a little different now from how they were in Goffman’s time, the ‘total institution’ was still the main conceptual apparatus I received from my professional training to think through these places. Contributing towards addressing that gap, even slightly, was part of my motivation for taking on this project. The other part was that I have always been drawn to working with people with complex psychosis. I have learned so much from them, mainly about the limits of my own frameworks and my own imagination, but also about the complex, conflicting, and sometimes unexpected roles that institutions play in their lives. This is poorly captured in a clinical evidence base that, on the whole, tends to privilege streamlined understandings and analytic closure. I thought that ethnography could be particularly useful here—to help us hold onto that complexity as we make pragmatic decisions about care.

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

Music and sport are big parts of my life. Both were important for this study. I bonded with Shepherd over a shared love of sport, and when I think of Apollo Ward I mainly think of playing pool and taking requests to play music on my phone—Orbital, Ed Sheeran, the Darkness, and the Rolling Stones were the soundtrack to this study. So now I’m watching my beloved Liverpool play football again after celebrating England Lionesses win the European Championship, and I’m listening to a lot of exciting British and Irish post-punk bands—Big Special, Wet Leg, and Sprints at the moment. I also recently started reading The Brown Sahib Revisited by Tarzie Vittachi, a searing takedown of the legacies of British colonialism in South Asia that was a wonderful gift given to me by my mentor and friend Sushrut Jadhav.

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

That we need to take people’s ambivalent feelings and contradictory dispositions towards mental health services seriously in imperfect systems, even if it makes us uncomfortable. These contradictions may be our only glimpses of the life-sustaining roles that some institutions play in people’s lives. That is not to say that we should avoid radical critique, just that we need to proceed with caution. It is easy to miss complexity in this field, and missing complexity has material consequences that tend to impact the most marginalised people disproportionately.

Interview With Jennifer Karlin

Posted by matthewbmartinelli

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

Associate Professor, University of California-San
Francisco

Dr. Jennifer Karlin is an Associate Professor at UCSF. With fellowship
training in family planning and clinical medical ethics and a PhD in anthropology and history of medicine, Dr. Karlin is a researcher and full-scope family physician whose work aims to find ways to empower people through their healthcare experiences.

What is your article “Intimacy, Anonymity, and “Care with Nothing in the Way” on an Abortion Hotline” about?

The article explores the operations and emotional dynamics of a reproductive health hotline. It examines how the hotline offers intimate, yet anonymous support to individuals seeking information about miscarriages and abortion. This support system is characterized by a non-judgmental and compassionate approach, providing “care with nothing in the way.” The hotline serves as a crucial lifeline, offering both emotional support and vital information during a potentially distressing time for callers. Despite the anonymity, the interactions create a safe and supportive environment where callers can freely express their concerns and receive guidance without the fear of stigma or judgment. Volunteers on the hotline often find the experience more rewarding and impactful compared to in-clinic care, as they can connect deeply with callers in a unique and supportive manner without having the regulatory climate that often can cause additional trauma to people seeking in-person care through more formal networks.

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

As a board-certified family physician and fellowship-trained family-planning specialist, my research bridges clinical practice with anthropological inquiry to enhance person-centered care for historically underserved populations. My background in anthropology and history of medicine informs my understanding of how social, political, and institutional structures shape health care experiences. I investigate a range of topics, including rheumatoid arthritis, grief, end-stage renal disease, reproductive and sexual health, and community engagement in medical research. My work emphasizes ethically informed care, empowering individuals through biopsychosocial analysis, patient-care team dynamics, and structural aspects of health systems. In reproductive health, I focus on de-medicalizing contraceptive methods and abortion care to reduce stigma. Additionally, I examine access to care for vulnerable populations and the incorporation of DEI initiatives in medical education. Through interdisciplinary research, I aim to improve complex disease management and promote equitable health care by challenging and reimagining traditional norms and structures.

What drew you to this project?

I was inspired by this project because of my long-standing interest in understanding and improving person-centered care for historically underserved populations. This was a natural field site to explore my commitment to de-medicalized and de-stigmatized care. This hotline offered an invaluable opportunity to examine how intimate, anonymous support can profoundly impact individuals seeking abortions, providing insights into creating more compassionate and accessible reproductive health services in all settings. Additionally, my interest in how social, political, and institutional structures affect health care experiences motivated me to think about how hotlines can serve as crucial resources within these contexts.

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

I just started reading ‘High Magick’ by Damien Echols, which explores the spiritual practices Echols
developed while wrongfully imprisoned for murder. A marathon swim group recommended it to me for
its mental training techniques, as I am currently preparing for a 21-mile open water swim.

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

A main action takeaway from the paper “Intimacy, Anonymity, and ‘Care with Nothing in the Way’ On an
Abortion Hotline” is the recommendation to support and expand support for informal structures of care.
The hotline provides a crucial space for individuals to receive compassionate, non-judgmental support
and guidance in a stigmatized and often challenging context. The anonymity and intimacy offered by
these services can significantly improve the quality of care and emotional support for those pregnant
people, emphasizing the importance of such resources in reproductive health care systems.

Other places to connect:

Website

SfAA 2017 Conference Feature Part 2: “Experiences and Identity in Long-term and Chronic Illnesses”

Posted by sonya.petrakovitz

This week on the blog we are continuing our feature of a paper session from the 2017 Society for Applied Anthropology (SfAA) Annual Meeting which took place in Santa Fe, New Mexico from March 28th through April 1st. This session was entitled “Experiences and Identity in Long-term and Chronic Illnesses” and featured Beth Moretzsky, Karen Dyer, Marlaine Gray, and Ellen Rubinstein (full program from the SfAA meeting available here). Here, we present a summary of Karen Dyer and Marlaine Gray’s presentations. Part one of this feature is available here.

Karen Dyer (VCU) – Examining Health and Illness after Treatment for Colorectal Cancer: Long-term Healthcare Needs and Quality of Life

From her research, Dyer discusses the attachments formed between people with a history of colorectal cancer and their oncology team, which stems from both a fear of recurrence of illness and an especially strong emotional bond forged through mutual experiencing of a life-threatening disease. Dyer also discusses the consequences of the ambiguity of cancer follow-up care. Questions frequently include, who is the best doctor to see? If multiple care providers are seen by people with a history of colorectal cancer, will tests will be duplicated or even missed? Which emerging symptoms are serious enough to warrant further investigation? This continuing surveillance of a “survivor’s” body encompasses many medical repercussions from the treatment of cancer and reality of recurrence risk, often transforming people into life-long patients.

Dyer interviewed 30 participants in Virginia who had a history of colorectal cancer and were at least five years post-treatment. As this category of people with a history of colorectal cancer increases, there is a growing number of individuals using, and in need of, follow-up care. Yet this need is contrasted against a shortage of oncologists and primary care providers who are able to treat this group of people. Dyer asks, how do we treat and provide adequate long-term care to people for years, possibly for the rest of their lives, in a way that is not going to compromise or strain the oncology clinics? What are the physical, social, and emotional needs of longer-term colorectal cancer “survivors,” and how does their cancer experience impact these needs?

Dyer explains that most participants with a history of colorectal cancer did see an oncology team regularly for a follow-up care. For this group, as with other groups with specific types of cancer histories, the five-year mark is a critical period where individuals get discharged from monitoring and care because the risk of recurrence is statistically very low. Yet from Dyer’s research, a large number of her participants were planning to continue to see their oncology team after they had passed the five-year mark. Most had no formal “survivorship” care plan, and in general, there was not an understanding of what future care would entail.

Many individuals with a history of colorectal cancer continue to see their oncology team because of the intense bond and emotional connection they have developed. Going through a serious life-threatening experience created an attachment and deep sense of friendship. Dyer discusses that the oncology team fills a role of social friendship and support during the cancer experience when many other relationships may change. For Dyer’s participants, the oncology team has seen them in their “worst moments” and guided them through this demanding treatment. This type of connection and support is difficult to abandon. One woman said, “I need my security blanket, and yeah, I guess that’s what Dr. L [her oncologist] is.” This sense of being cared for and understood will be greatly missed. Any kind of care planning needs to take that strength of bond and trust into account.

Ambiguity surrounding cancer follow-up care is also an important dimension of Dyer’s work. Many participants report difficulty several years post-treatment when symptoms or health problems manifest in uncertain ways. Participants report difficulties distinguishing between normal aging processes, potential non-cancer related problems such as diabetes, or potential cancer-related, or cancer treatment-related, effects. Dyer uses fatigue as an example. Many participants spoke about being considerably more fatigued than they usually were. While this fatigue could be part of a normal aging process, it could also signal a variety of diseases or indicate the arrival of a cancer recurrence. Ambiguous symptoms such as fatigue lead to a high stakes, complex decision-making process.

People experiencing these types of indistinct symptoms often express an uncertainty about who they should contact with questions and when. Participants frequently did not want to “bother” their oncologist or be perceived as overreacting. Self-diagnosis and self-assessments of the level of seriousness of these symptoms were often the responses.

Marlaine Gray (GHC) – Shouldn’t We Be Listening?: Using Twitter for Recruitment, Patient Engagement, and Data Collection in a Study about How Young Adults with End Stage Cancer Make Medical Decisions

Gray begins by discussing research methodological complications when researching young people with metastatic cancer who are geographically spread all across the United States. It can be difficult to find and access this understudied population. Gray also discusses the sensitive nature of the topic is often compounded by time constraints; asking a patient for an hour of their time as part of an interview is difficult when that individual may not have a lot of time left.

Using an already active Twitter community, Gray investigated how young adults with metastatic cancer made medical decisions and whether or not their care matched their ultimate goals. The research was called The Clare Project, named after and featuring a personal story of metastatic cancer. The intention was to understand what these patients wanted for their remaining life and quality of life and translate those goals back into the medical discourse in order to match up treatments. Most participants wanted more quality time with their family, yet they were often being advised to get surgeries. Gray explains this disjunction can be problematic since metastatic cancer patients may never return home from the hospital after these types of surgeries, or they be unable to recover completely and be unable to fully engage with their families again.

Twitter became a way to contact people who were already publically speaking about their cancer experiences. The population of young people online is very active in seeking treatment, finding other patients to connect with, and finding out what the treatments are like. While there are also blogs, threads like Reddit, Facebook groups and pages, and other online message boards, Twitter emerged as the most successful way of communicating with this population. People are online constantly to discuss their cancer experiences.

The metastatic cancer Twitter community uses hashtags such as #mayacc (metastatic adolescent and young adult cancer community), #hpm (hospice and palliative medicine), or #metsmonday, where people with metastatic cancer post about their experiences on Monday. After launching their call for recruitment on Twitter, the Clare Project (Twitter page available here) achieved 200% of their recruitment goal within 24 hours. By using established hashtags and following prominent community members, Gray was able to reach an extensive participant audience.

Adolescent and young adult cancer patients are already actively using social media, many joining Twitter after their diagnosis. Twitter becomes a means of social connection. Gray articulates people are using Twitter to discuss decisions they have to make surrounding their metastatic cancer treatments. Even though patients talk with their doctors and family members, they are using the Twitter support groups to find out what the treatment experiences are. It is these treatment narratives from fellow metastatic cancer sufferers which holds more decision-making weight. Some of these decisions are very high stakes and are based on their peer, rather than medical, advice.

Accessing the first-hand expertise of other patients is labeled as a different kind of expertise than they can get from the medical community. Additionally, for side effects, participants express that doctors can tell them what the treatment is, but their fellow patients will express what the treatment is like and how to manage it. This social support is crucial when participants often do not know anyone else with these types of cancer.

Gray also discusses a kind of “legacy activism,” where people would know they were terminal with few options in their own treatment, but they wanted to advocate for more research funding and attention to metastatic cancer. Social media became a way to engage in social activism. Even though people could not physically go to advocacy events, they could virtually participate from their bedrooms and still spread their message. Through Twitter, people can participate in research and campaigning who would otherwise be unable to do so.

Book Release: Tomes’ “Remaking the American Patient”

Posted by jknopes

Images via UNC Press website

Released in January 2016 from the University of North Carolina Press is Nancy Tomes’ Remaking the American Patient: How Madison Avenue and Modern Medicine Turned Patients into Consumers. Through historical and cultural analysis, Tomes illuminates the threads between public relations and marketing in medicine, asking throughout: how have patients in the United States come to view health care as a commodity to be “shopped” for? What connections are shared between the history of medicine and the growth of consumer culture? Likewise, Tomes investigates what it means to be a “good patient” in this system of marketed care, and how “shopping” for care can both empower and disorient patients in the contemporary age. She also reviews the resistance, and ultimate yielding, of the medical profession to this model of care seeking. The book was recently reviewed in the New York Times (read the article here.)

The book will prove insightful for both historians of medicine and medical anthropologists who study the political-economic landscape of biomedicine and patienthood in the United States. It will also speak to conversations in bioethics about patient autonomy, choice, and medical decision-making.

About the Author

Nancy Tomes serves as professor of history at Stony Brook University. She is also the author of The Gospel of Germs: Men, Women, and the Microbe in American Life, published by Harvard University Press (details here.)

Have you published a recent book in medical anthropology, history of medicine, social medicine, or medical humanities? Email our blog editor (Julia Knopes) at jcb193@case.edu with a link to the book’s page at the academic publisher’s website, and we will feature it here.