Interview with Soha Bayoumi

Posted by nusaibasc

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

Soha Bayoumi is a Senior Lecturer in the Medicine, Science, and the Humanities Program at the Johns Hopkins University. She is presently completing two book projects, one (with Sherine Hamdy) on the work of doctors in the Egyptian uprising, and the other on the social and political roles of doctors in relation to health and justice in postcolonial Egypt.

What is your article “Nationalism, Authoritarianism, and Medical Mobilization in Post-revolutionary Egypt” about?

This article explores the links between medical practice and expertise, on the one hand, and nationalist discourses, on the other, in the context of the 2011 Egyptian uprising and the years that followed, which witnessed a consolidation of political authoritarianism. It investigates how doctors played a significant role in countering political regimes’ acts of violence and denial. It traces the trajectory of the doctors’ mobilization in the 2011 uprising and beyond and demonstrates how the doctors drew on their professional expertise and nationalist sentiment in their struggles against a hypernationalistic military state. It contrasts activist doctors’ idea of nationalism with the state’s and shows how medicine has served as a site of awakening, conversion narratives, and building of bridges in a polarized society where the doctors were able to rely on their “neutral” expertise to present themselves as reliable witnesses, narrators, and actors.

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

I work at the intersection of the history of medicine, science and technology studies, and political theory. My work is informed by postcolonial studies, gender studies, and social justice, and centers the ways in which medical expertise is shaped by and deployed in different political contexts.

What drew you to this project?

This research is part of a book-length project that I have been working on for the good part of the last decade with Sherine Hamdy. We were both amazed and intrigued by the different roles played by doctors in the Egyptian uprising and its aftermath and felt compelled to document that episode of the Egyptian revolution and ask questions related to what motivates doctors to engage in politics, especially during such volatile political moments.

What was one of the most interesting findings?

We were really struck by how doctors reliance on their “neutral” expertise and their attempts to efface the political in their work actually reinscribe the political in different ways, in ways that both allow doctors to either resist state violence or abet it.

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

I’m currently watching the Netflix show, Mo, which is, as far as I know, the first mainstream show about a Palestinian-American to ever make it to streaming screens in the US. I’m reading Oliver Sacks’ first memoir, A Leg to Stand On, which is focused on an accident that caused him to lose the use of one of his legs and his reflections on being patient, after a long career of being a doctor. And I’ve just finished listening to the audiobook, Born a Crime: Stories from a South African Childhood, by Trevor Noah. I love Trevor Noah’s style of comedy, and I think his autobiography book, which contains a lot of comedy, is best enjoyed performed by Noah himself.

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

I think it is the idea that very few things in life are actually politically “neutral”—that what we take for granted as apolitical or technical or neutral has so many ramifications on politics, writ large. Many of the daily actions we take and the statements we make are inscribed in a political context and often function to reproduce and perpetuate that context or to subvert and change it, if we so choose.

Thank you for your time!

Other places to connect:
Website
Twitter
LinkedIn
Academia.edu

Interview With Lamia Moghnieh

Posted by nusaibasc

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

Lamia Moghnieh (Postdoctoral Fellow, University of Copenhagen) is an anthropologist and mental health practitioner. Her research looks at the impact of psychiatry on understandings of self and illness in postcolonial and postconflict societies of the MENA/SWANA. She is interested in exploring the relationship between psychiatry and subject formation in the context of global mental health and patient subjectivities.

What is your article “The Broken Promise of Institutional Psychiatry: Sexuality, Women and Mental Illness in 1950s Lebanon” about?

I am an anthropologist, psychologist, and a social worker, and more recently, I am also a patient of analytical therapy. I try to let my research be informed from all of these positionalities together or provide insights from all of these places (as a researcher, practitioner and from the more intimate and vulnerable position of being a patient). I work in the field of mental health, and I do research on the histories and ethnographies of psychiatry, tracing various discourses on mental health from the Middle East and North Africa/ Southwest Asia and North Africa). I am currently writing my book manuscript provisionally entitled “Psychiatric Afterlives: Narrating Illness, Gender and Violence in Lebanon”. The book builds on multi-disciplinary frameworks from medical humanities to examine the role of psychiatric expertise in shaping patient and social imaginaries of madness and violence in Lebanon.

What drew you to this project?

I always wanted to be a clinical psychologist until I enrolled in the MAPSS program (Masters’ in the Social Sciences) at the university of Chicago. There, I was introduced to the various historical, philosophical and political critiques of psychology and I was drawn to medical anthropology. After I finished my PhD, which focused on trauma, humanitarianism and the politics of suffering in Lebanon, I was interested in learning more about the history of psychiatry in Lebanon and the region. My background and research interests are interdisciplinary. I am lucky to be in an academic position (at the upcoming research center “Culture and the Mind” head by Ana Antić at the University of Copenhagen) that welcomes and values this interdisciplinarity in the study of psy disciplines.

What was one of the most interesting findings?

One of the findings that interest me is the ways in which the family acts as an equal diagnoser of mental illness to psychiatric expertise. As shown in the article, the story of Hala invites more attention to the ways in which women (and maybe non-normative persons) become chronically institutionalized by institutional psychiatry and the family. This is not to dismiss the psychological and financial effects that mental illness might have on family members. The article rather approaches the family as a sociological unit that governs and defines normality, and is interested in the dialogue, tensions and challenges of care and normality between the family and institutional psychiatry, as shown in the story of Hala.

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

Audre Lorde’s Zami: A New Spelling of My Name
Roberto Bolaño’s Cowboy Graves
سارة اب وغزال “احلمي يا سيدي
هلال شومان “حزن في قلبي
Couch Fiction: A Graphic Tale of Psychotherapy
Jonathan Sadowsky’s Empire of Depression: A New History

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

That psychiatry is both a form of governance and a mode of healing whose authority and reach transforms and changes over time. That patient voices and narratives are a crucial part of the history of psychiatry and of its contemporary practices. And that medical humanities, including anthropology, is a field that can offer useful and critical insights on the status of global mental health.

Other places to connect:
Website
Twitter
LinkedIn

Interview with Michael Galvin

Posted by nusaibasc

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

Dr. Michael Galvin is a Global Psychiatry Clinical Research Fellow and in the Department of Psychiatry at Harvard University and the Department of Psychiatry at Boston University. Dr. Michael Galvin is a global health researcher and psychotherapist. His primary research interests center on mental health and the role that one’s environment, culture, and belief systems play in mental illness and treatment. In particular, his work focuses on elucidating cultural models of mental illness and exploring relationships to pathways to care, with the goal of improving cultural adaptation of mental health interventions.

What is your article “Examining the Etiology and Treatment of Mental Illness Among Vodou Priests in Northern Haiti“ about?

This article is about the way that traditional healers (ougan) conceptualize and treat mental illness in rural Northern Haiti. While the vast majority of people with mental illness seek treatment from ougan in this region – as few biomedical services exist – very little research has examined what ougan actually do when treating patients. The article also tries to understand how mental illness is viewed from the healer’s perspective, delving into the broader Vodou cosmology which remains very influential in rural parts of Haiti.

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

My interests mostly center around mental illness and how we conceptualize it in different cultures and settings. Historically, mental illness has always been hard for people to understand, getting wrapped up in ideas of spirit and demon possession. Rarely have people thought it was something to treat like a broken leg or even a bacterial infection. This is partly because there are no biomarkers to test for it thus patients recount what they are experiencing solely via self-report. But it’s also because mental illness affects the basic ways in which people act and simply exist in the world. When our loved ones have significant behavioral changes without physical symptoms of illness or infection it can often lead us to suspect the supernatural.

What drew you to this project?

I have been working and living in Haiti on and off since 2012 and knew I wanted to focus my dissertation research in Cap-Haïtien. I found out about the Mental Health Center at Morne Pelé in 2018 and spent the entire summer of 2019 volunteering with them so we could get to know each other, for me to better understand what their work was like, and to start exploring different angles for my dissertation research which I conducted in the second half of 2020. It was during the summer of 2019 that I learned about the extent to which patients held explanatory models based in Vodou and I knew that had to become a significant part of my research there. I’m currently the director of the Mental Health Center at Morne Pelé’s new Research Laboratory so it’s very exciting to continue to collaborate together.

What was one of the most interesting findings?

One of the most interesting findings was this treatment called fiksyon that almost all the healers I interviewed used. Barely anything has been written about these concoctions so this was really one of the first times they’ve been explored. Fiksyon are different liquids – usually rum mixed with ground plants and animals – that are kept in large unmarked semi-transparent plastic bottles. There’s a lot of mystery surrounding fiksyon with many people saying they have mystical properties. It would be interesting to explore more about what is actually in them and the places where they are manufactured

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

I’m reading a really interesting book that was written in the 1970s called Plagues and Peoples. It’s a great dive into the history of pandemics over the centuries. It’s not a hard read at all, very enjoyable and easy to understand with lots of nice anecdotes. Apparently the findings have held up really well over the last 50 years too.

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

That religion and culture have deep impacts in the way we conceive of mental illness. That we still know relatively little about how mental illness develops, manifests, and is best treated. That the relationship between our minds and our bodies is exceedingly complex and there are often no easy solutions.

Thank you for your time!

Interview with Katarzyna Szmigiero

Posted by nusaibasc

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

Katarzyna Szmigiero is a graduate of the University of Łódź, Poland. She is an Associate Professor at the Institute of Literary Studies and Linguistics of the of University of Jan Kochanowski, Poland (Branch in Piotrków Trybunalski). Her research interests concentrate on medical humanities, especially cultural representations of psychiatry and gender, and genre fiction.

What is your article ““We All Go a Little Mad Sometimes:” Representations of Insanity in the Films of Alfred Hitchcock“ about?

The article deals with the way motifs connected with psychiatry (doctors/treatment/people diagnosed with mental illness or individuals displaying disturbing behavior/attitudes to mental psychopathology) are used in the films of Alfred Hitchcock. First of all, it tries to answer the questions why the director so often presented mentally unstable characters in his works. It also looks at how Hitchcock gently questioned the assumptions about mental illnesses and its origins that were dominant in his times. Finally, it briefly mentions the legacy of Hitchcock if the cinematic portrayals of insanity are concerned.

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

I am interested in cultural representations of madness, gender studies, and popular literature.

What drew you to this project?

I have always loved Hitchcock’s films and saw Frenzy in my early teens, as it was my dad’s favourite. It was one of the most unpleasant and, simultaneously, hilarious film I have ever seen since.

What was one of the most interesting findings?

On the surface, Hitchcock appears to be following the psychoanalytic approach, especially in his American movies. However, he always undermines the official discourse on madness, proving that we are all, sometimes, a little mad and there’s nothing wrong about it.

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

I am currently an avid reader of the retellings of the Medusa myth (as well as other chick lit fantasy books about antiquity).

Watch Hitchcock! Old films may seem dated, especially if you are not used to them. But his dialogues, designs, cast is often genius.

Thank you for your time!

Interview with Clare Killikelly

Posted by nusaibasc

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

Dr. Clare Killikelly is a Post-Doctoral Research Fellow in the Department of Psychiatry, University of British Columbia, and Department of Psychology, University of Zurich. Dr. Kilikelly’s research group examines the clinical utility and global applicability of the new Prolonged Grief Disorder. Her research seeks to better understand the nature of suffering and distress in different communities to develop accessible and culturally informed assessments and interventions.

What is your article “The New ICD-11 Prolonged Grief Disorder Guidelines in Japan: Findings and Implications from Key Informant Interviews” about?

Symptoms of mental disorder, including grief reactions, are found to differ across cultures. There are several examples where misdiagnosis of mental disorders, treatment gaps, and reduced help seeking occurs when culturally sensitive assessments are lacking. The identification of culturally unique symptoms of grief can improve the validity of mental health assessment.

We are the first to explore PGD symptoms in Japan from the perspective of frontline health care workers. We conducted in depth key informant interviews with cultural brokers (e.g. individuals who are part of the health care system but also have lived experience of the cultural group).

We had two main aims: first to explore experiences of grief to define both normal and abnormal reactions. Secondly, we assessed the acceptability of the ICD-11 guidelines to identify areas where cultural information is lacking. This would provide a unique viewpoint that is often overlooked in larger qualitative studies.

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

I am interested in the role of culture in the presentation and treatment of mental health disorders. I believe that there may be cultural concepts that when unlocked can provide a key to better therapeutic outcomes.

After completing a PhD in Cognitive Neuroscience at the University of Cambridge, UK, I became interested in the core cognitive processes underlying psychopathology and the development of targeted psychotherapeutic interventions. I completed a Doctorate in Clinical Psychology at the Institute of Psychiatry, Psychology and Neuroscience, UK and explored the use of innovative mobile technologies to improve the acceptability and efficacy of therapeutic interventions for people with psychosis. Working as a psychologist with refugees in South London I became interested in the different cultural experiences and presentations of distress.

Currently, I have been awarded a Swiss National Science Foundation (SNSF) Post-Doc Mobility grant to work at the University of British Columbia to examine the relationship between grief, indicators of mental health and post migration living difficulties in refugees in Canada in comparison with Swiss, Dutch and German cultural contexts.

If you are interested in learning more about this research project, or possibly participating please check out the website.

What drew you to this project?

Prolonged grief disorder is the only mental disorder where people are expected to suffer. However, the intensity and duration of this suffering is bound by different cultural norms. For example, in German speaking countries it is common to observe a Trauerjahr (year of mourning) whereas in Syria there are 40 days of mourning. The new ICD-11 definition of PGD states that individuals must experience intense and prolonged symptoms of grief for over 6 months. Although there is robust research evidence that supports this time criteria in the Global North (e.g. North America and Europe), the current definition of PGD may be missing key symptom items and features that are more representative in different cultures.

Ultimately, we would like to develop a catalogue of culture concepts of distress (CCD) that could be accessed worldwide to help clinicians more accurately assess and diagnose PGD in different cultural groups.

What was one of the most interesting findings?

Part of the analysis focused on establishing common grief symptoms for disordered grief in Japanese bereaved. Participants described a range of emotional responses that are associated with both normal and abnormal grief responses. One unique emotional response was identified related to sadness: The sense of loss was described using a metaphor for distress ‘as a hole opening up inside the kokoro (heart).’

The in-depth qualitative analysis provided insight for clinical application, for example, due to

prominent values of emotional control, stigma towards mental illness, or lack of somatic items in the assessment measure, PGD may be underestimated in Japanese culture with the current ICD-11 PGD guidelines.

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

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

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

We were able to identify new symptoms that are very relevant for the Japanese context that are currently missing from the ICD-11 PGD definition. For example, somatic symptoms are robustly endorsed in the Japanese context, however, these are largely missing from the PGD ICD-11 definition. On the other hand, yearning and longing for the deceased (a core symptom of PGD ICD-11) is considered a normal and encouraged process, related to the emphasis on continuous bonds. Clinicians will need to consider these possible cultural differences before diagnosing PGD in the Japanese context. Considering the deeper beliefs and values of a culture and how this may impact on the assessment of grief is of great importance.

Thank you for your time!

Other places to connect:
Website
International Counseling
LinkedIn

Interview with Sarah Rubin and Joselyn Hines

Posted by nusaibasc

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

Sarah Rubin is an Associate Professor at the Ohio University Heritage College of Osteopathic Medicine at the Cleveland campus. She is a medical anthropologist who studies motherhood in the US and South Africa. She’s an advocate for health equity and reproductive justice. She lives in rural northeast Ohio with her family.

Joselyn Hines is a fourth-year medical student at the Ohio University Heritage College of Osteopathic Medicine at the Cleveland campus and psychiatry residency applicant. She has held many leadership positions within her medical school and local community. She is an active advocate and leader for underrepresented minority medical students and marginalized patient populations. She is passionate about destigmatizing mental illnesses and connecting the community to proper psychiatric care.

What is your article “As Long as I Got a Breath in My Body’’: Risk and Resistance in Black Maternal Embodiments” about?

This article explores the everyday experiences of Black mothers in Cleveland, OH as they navigate pregnancy and postpartum in the context of the racially disparate risk of infant death due to structural racism. These mothers articulated awareness of ways that racism causes them stress as they strive to have a healthy pregnancy and birth and raise their children well. We describe an embodied orientation toward motherhood that we call “betterment” where women attempt to overcome the disadvantages and oppressions of structural racism by centering their children, reconsidering and reconfiguring the social support they need to raise them, and by focusing on the future.

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

Rubin: I’ve always been fascinated by reproduction and motherhood and understanding “what it’s like” to mother in different contexts and circumstances. I work with mothers in South Africa as well as the US. Ethnography is my favorite way of engaging in research, but I also enjoy the breadth and multidimensionality of interdisciplinary collaborations. My favorite way to do research, though, is by engaging and mentoring students.

Hines: I am passionate about research on chronic stress in Black woman and its impact on the maternal and infant mortality health disparity in Cleveland, Ohio. I am interested in women’s mental health, reproductive psychiatry and child and adolescent psychiatry.

What drew you to this project?

Rubin: When I learned about the great racial disparity in infant mortality around our campus in Cleveland, OH and the role of chronic stress in creating and maintaining that disparity, I wondered what it looked like and felt like to mother under those conditions. We started with that phenomenological question, and it led us to an understanding of how structural racism is experienced and resisted by Black mothers.

Hines: Black women’s voices are often silenced and objectified in medicine. This project amplifies the voices and stories of Black women and sheds light on the struggles and obstacles that black women face and overcome to successfully parent.

What was one of the most interesting findings?

The Black mothers in our study demonstrate a love and commitment to their children that defy pathologizing discourses like “Welfare Queen;” but they also disrupt the positive trope of the “Superstrong Black mother,” which renders invisible the hardship and grief of living and mothering in a racist society. Our findings forge a middle path by showing how Black mothers’ bodies are shaped by the chronic stressors of structural racism but are also a source of resistance, especially in service to their children.

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

Rubin: I’m reading Birthing Black Mothers by Jennifer C Nash. It’s a fascinating analysis of “Black motherhood” as a political symbol. It’s prompting me to reconsider my own analysis of Black motherhood, and also my positionality as a scholar. I’m also watching Season 10 of the Great British Baking Show. It’s a hug, nap, and cup of tea all rolled into one flaky pie crust. A working mother’s salve.

Hines: The Deepest Well: Healing the Long-Term Effects of Childhood Adversity by Dr. Nadine Burke Harris

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

Rubin: Listen to Black Mothers!

Hines: This project shows how social determinants of health are lived and embodied by vulnerable populations. Readers can use this information to better understand their perspective, provide holistic quality care, and to better advocate for systemic changes in society that can ultimately provide better health outcomes for and save the lives of Black mothers and babies.

Thank you for your time!

Other ways to connect:
Twitter: Sarah Rubin | Joselyn Hines
LinkedIn: Sarah Rubin
Other applicable website: Sarah Rubin

Interview with James B. Waldram

Posted by nusaibasc

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

Jim Waldram is a Distinguished Professor of Anthropology at the University of Saksatchewan. A canadian anthropologist with specializations in applied and medical anthropology, he obtained his PhD from the University of Connecticut in 1983, after completing Bachelor’s (University of Waterloo) and Master’s (University of Manitoba) degrees in Canada. He is the author of several books, including Hound Pound Narrative: Sexual Offender Habilitation and the Anthropology of Therapeutic Intervention (2012, University of California Press) and An Imperative to Cure: Principles and Practice of Q’eqchi’ Maya Medicine in Belize (2020, University of New Mexico Press). He is a Fellow of the Royal Society of Canada, the Canadian Anthropology Society, and the Society for Applied Anthropology.

What is your article “Does “Susto” Really Exist? Indigenous Knowledge and Fright Disorders Among Q’eqchi’ Maya in Belize” about?

This article examines the knowledge held by a group of Indigenous people – the Q’eqchi’ Maya of Belize – with respect to fright-related disorders. It challenges the idea that one particular fright disorder, known as susto, is essentially the same everywhere. Susto is well documented in cultural psychiatry, and the term appears in major psychiatric textbooks. But it appears to be an overlay of Indigenous knowledge by western psychiatric researchers, with the result that the complexities and nuances of Indigenous fright disorders are rendered invisible. This article takes that Indigenous knowledge seriously and uses it to talk back to susto, to question the rote applicability to Indigenous peoples of this particular western conceptualization of disorder.

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

I live in Saskatchewan, Canada, known for bright sunshine and long,hot summer nights, as well as cold, dark winters. So, researching in Belize is very nice! I have been working with a group of Q’eqchi medical practitioners, and their patients, for almost twenty years. I am intrigued by the concept of ‘healing’ and much of my work has examined therapeutic practice in settings such as northern Indigenous communities, prisons, clinics, and now southern Belizian Q’eqchi’ villages.

What drew you to this project?

I was invited by the Q’eqchi’ medical practitioners to research, document, and share their medical practice and knowledge, in response to efforts by evangelicals and others to paint them as satanic or charlatans.

What was one of the most interesting findings?

I had a notion of ‘healing’ as fundamentally about repairing social relationships and psychological harms, based on my work with Indigenous groups in Canada. I was surprised to find that the Q’eqchi’ medical practitioners – who some would refer to as ‘healers’ – are focused mostly on diagnosing and treating medical conditions and seeking a cure for their patients.

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

I don’t have much time for reading outside of my scholarly pursuits and teaching. I do listen to blues music regularly, and I watch a great deal of football (Canadian style).

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

It is imperative to take seriously the deep and complex knowledge of Indigenous peoples and allow their understandings and explanations to exist equally alongside those of western science.

Thank you for your time!

Other places to connect:
Website
Twitter

Interview with Daniel R. George

Posted by nusaibasc

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

Daniel R. George is an Associate Professor of Humanities & Public Health Sciences at Penn State College of Medicine.

He earned his Ph.D and M.Sc in medical anthropology from Oxford University. He is co-author of The Myth of Alzheimer’s (St. Martin’s Press, 2008) and American Dementia (Johns Hopkins University Press, 2021).

What is your article “Ancient Roots of Today’s Emerging Renaissance in Psychedelic Medicine” about?

We use a historical lens to examine the use of psychedelic therapies over time, translate ancient lessons to contemporary clinical and research practice, and interrogate the practical and ethical questions researchers must grapple with before they can enter mainstream medicine. Given the COVID-19 pandemic and its contributions to the global mental health burden, we also reflect on how psychedelic therapy might serve as a tool for medicine in the aftermath of collective trauma. Ultimately, it is argued that a “psychedelic renaissance” anchored in the lessons of antiquity can potentially help shift healthcare systems—and perhaps the broader society—towards practices that are more humane, attentive to underlying causes of distress, and supportive of human flourishing.

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

My main area of research is dementia and Alzheimer’s disease with a focus on supporting quality of life and using arts-based approaches in long-term care settings. More recently, I have grown interested in the Deaths of Despair crisis that is, in part, lowering life expectancy in the US. I am concerned about the mental health issues in this country, and that has helped lead me to be more open-minded about how psychedelics might have a role in caring for people who are in pain. I have also been thinking recently about how psychedelic approaches—perhaps microdosing—might potentially be useful in long-term care settings, especially given the lack of anti-dementia drugs. I am also broadly interested in public and community health and have helped start a farmers’ market and community garden on our hospital campus.

What drew you to this project?

The Deaths of Despair crisis and the magnitude of mental health challenges we face has been a main path into psychedelics research. In this paper, we ask whether we can learn anything in our current therapeutic milieu by studying and appreciating how human beings have used psychedelics for millennia.

What was one of the most interesting findings?

The preliminary data showing the effectiveness of psychedelics and guided therapy in, for instance, treating depression, death-related anxiety, PTSD, eating disorders, and other conditions is quite striking. Much more needs to be investigated, but there is something here worth exploring, scrutinizing, and pursuing.

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

I just started The Brothers Karamazov. Have also recently been reading random passages from the Bhagavad Gita.

If there was one takeaway or action point you hope people will get from your work, what would it be? Not to reject psychedelics out of hand and to try to separate these compounds from the culture war discourse that has shaped our perceptions of them since the 1960s. We need to burst out of that paradigm and think imaginatively, empathetically, and, of course, scientifically, especially given the scope of mental health challenges we face.

Thank you for your time!

Other places to connect:
Website
Twitter

AAA 2017 Session Highlight: Jonathan Metzl, “Negroes With Guns: Mental Illness, Gun Violence, and the Racial Politics of Firearms”

Posted by sonya.petrakovitz

This week on the blog we are highlighting an oral presentation given at this year’s annual American Anthropological Association conference in Washington D.C. by Jonathan Metzl entitled Negroes With Guns: Mental Illness, Gun Violence, and the Racial Politics of Firearms. The session was named “Critical Inquiries: Violence, Trauma, and the Right to Health” on Thursday, November 30, 2017. Metzl combined historiographical and ethnographic analysis to explore the connections between gun violence, mental illness, and shifting anxieties about race in the United States. Metzl discussed how decisions about which crimes American culture diagnoses as “crazy,” and which crimes it deems as “sane,” are driven as much by the politics and anxieties of particular cultural moments as by the innate neurobiologies of particular assailants. The presentation concluded by describing how racialized questions of whether “the insane” should be allowed to bear arms become the only publicly permissible way to talk about questions of gun control while other narratives, such as the mass psychology of needing so many guns in the first place or the anxieties created by being surrounded by them, remain silenced.

Metzl began his presentation by stating that after the recent and tragic Las Vegas mass shooting, he gave 58 interviews in only two days on “the insane politics of mass shootings.” The two main questions that get asked after each mass shooting are: “Is mental illness the cause of mass shootings?” and, “Will treating mental illness stop gun crime?” Both conservative and liberal media analyses include these types of questions, whether or not they ultimately claim mental illness as the answer (for example: NPR’s On Point, Politico, and Fox News).

Yet Metzl asked, why do these mental illness questions follow after mass shootings? “Aren’t these questions starting to be ridiculous?” Metzl asked, after referring to a study published in the journal Aggression and Violent Behavior which found some mass murderers and serial killers have something in common: autism and head injury. Yet this study was criticized for fueling judgments about an entire section of society and further contributing to the mental illness-gun violence debate.

In some ways, linking mass shootings and mental illness makes sense. Mass shootings are beyond the realm of “sanity” and understanding. Metzl stated that constructing a binary of sane vs. insane, good vs. evil, may be a means of processing grief and uncertainty. Further, many of the mass shooting perpetrators in the last decades have displayed some kind of mental illness symptomatology before their crimes. Mother Jones published an investigation of US mass shootings from 1982-2017 including information on the shooter’s race, gender, prior signs of mental health issues, mental health details, and whether or not the weapons were obtained legally. But this information cannot lead to a causal argument.

These types of questions have ideological and political roots, and focusing exclusively on issues of mental health force other concerns out of the debate. At a National Rifle Association (NRA) press conference in December 2012, chief executive Wayne LaPierre suggested having “an active national database for the mentally ill” would help prevent gun violence. In 2013, Ann Coulter wrote a Sound Off on Fox Nation entitled “Guns Don’t Kill People, The Mentally Ill Do.” After the 2015 Planned Parenthood shooting in Colorado Springs, Paul Ryan called for a need to look at fixing our nation’s mental illness health system, not it’s gun legislation. Most recently, following news of the mass shooting of parishioners at a Sunday service at a small Baptist church in Texas, Trump proclaimed mental health was the overarching issue, not gun control, even before complete details of the shooter were known.

Following this overview of political ideologies shaping the mental illness conversation, Metzl then asks, “What can reasonably minded people do to push back?”

Metzl then presented five talking points about important ways to push back against the mental-illness-and-mass-shooting account while still remaining respectful of mental illness, treatments, and medications. These talking points discuss why this association is problematic.

1. “It’s sample bias – and dangerously so…”: Mass shootings come to stand for all shootings. But mass shootings are not the only time we need to talk about gun violence, Metzl stated. When we talk about mass shootings, we are not talking about policy implications for everyday gun death. Every day gun violence, gun proliferation, the ability to buy guns through loop holes should all be part of the national conversation. Worryingly, Metzl states, the situation is about to get much worse. Today (Wednesday, December 6, 2017) the House will vote on a “concealed carry reciprocity” bill, creating a national blanket right to carry a concealed weapon across state lines. For Metzl, the point overall is that the mental illness narrative distracts from daily gun violence and the political negotiations behind gun regulations.

2. “It’s stigmatizing and misrepresentative…”: Fewer crimes involve people with mental illness. People with sanity are much more dangerous, Metzl stated. People diagnosed with a mental illness are less likely to shot other people, therefore we should really be restricting guns from the sane. Further, Metzl stated that statistically there is no predictive value in using a mental illness diagnosis for gun crime. Individuals with mental illness are more likely to be shot by police than to do the shooting themselves.

3. “It constructs false psychiatric expertise…”: Psychiatrists are being told they should be able to predict which of their patients may commit violent act. Yet the pool of people they see are not a high risk population. Metzl stated the public culture of fear may lead psychiatrists to feel culpable for the actions of their patients, over-report their concerns, and complicates the doctor-patient confidentiality bond. In the weeks before the Aurora, Colorado movie theater shooting, shooter James Holmes was seeing a psychiatrist specializing in schizophrenia. In June 2012 The Brian Lehrer Show discussed how psychiatrists determine red flags with their patients and when behavior is concerning enough to warrant further action with Columbia University Director of Law, Ethics, and Psychiatry Paul Appelbaum.

4. “It detracts from awareness of true predictive factors for everyday gun violence…”: The mental illness narrative also detracts from other risk factors for everyday gun violence and mass shootings. Substance use or abuse, past history of violence, lack of gun training, social networks, and access to firearms are all important predictive factors for gun violence.

5. “It’s racist…”: Last but certainly not least, the construction of a mentally ill, dangerous, white, male, gun-owning “loner” is a political choice. The intentional presentation of the individual-isolated-from-society is not supposed to be representative of white culture. Yet in the 1960s, the FBI openly blamed “crazy” black “culture” for the rise of public black activist groups. In debates leading up to the Gun Control Act of 1968, the U.S. Government and mainstream US culture proclaimed links between African American political protest, guns, and mental illness in ways that intensified fears about black activist groups. For example, FBI profilers diagnosed Malcolm X with “pre-psychotic paranoid schizophrenia” and with membership in the “Muslim Cult of Islam” while highlighting his militancy and his “plots” to overthrow the government. The FBI also hung “Armed and Dangerous” posters throughout the southern states warning citizens about Robert Williams, the controversial head of the Monroe, North Carolina chapter of the NAACP author of a manifesto, Negroes With Guns, that advocated gun rights for African Americans. According to the posters, “Williams allegedly has possession of a large quantity of firearms, including a .45 caliber pistol… He has previously been diagnosed as schizophrenic and has advocated and threatened violence.”

These historical narratives were linked to black culture, not black individuals. Issues of race and insanity produced black male bodies coded as insane. This association fostered fears that helped mobilize significant public and political sentiment for gun control. Yet there are very different politics of the present day. Metzl states were are in a time when white shooters with mental illness beget reaffirmations of gun rights and groups that advocate anti-government platforms and support broadening of gun rights, such as the Tea Party, take seats in Congress rather than being subjected to police scrutiny. For much of our country’s history, guns marked whiteness.

Metzl concluded his presentation with a discussion of a helplessness narrative. There is a kind of inaction about calling mass shootings and gun violence part of mental illness. Since we can not do anything about whether or not individuals have mental illness, it allows us to ignore the other issues and risk factors. This further constructs a kind of persons, not a composition of something larger and more systemic. The learned helplessness surrounding gun crime in the US makes hard rhetorical work to not look at whiteness and mass culture as part of the problem.

Jonathan Metzl, MD, PhD is the Frederick B. Rentschler II Professor of Sociology and Medicine, Health, and Society, Director for the Center for Medicine, Health, and Society, and Professor of Psychiatry at Vanderbilt University. He is also the Research Director of the Safe Tennessee Project, a non-partisan, volunteer-based organization that is concerned with gun-related injuries and fatalities in the United States and in the state of Tennessee. His areas of expertise include mental illness and gun violence with a particular focus on gender and race.

Learn more about Jonathan Metzl at his website, available here.

Book Release: “The Recovery Revolution: The Battle Over Addition Treatment in the United States”

Posted by sonya.petrakovitz

This week on the blog we are highlighting a new book by Claire Clark from the Columbia University Press entitled The Recovery Revolution: The Battle Over Addiction Treatment in the United States (2017). As the opioid crisis in the United States is continuing to make headlines, Clare traces the history of addition treatment and embeds developments in the social, political, and cultural moments from which they arose.

via Columbia University Press website

“In the 1960s, as illegal drug use grew from a fringe issue to a pervasive public concern, a new industry arose to treat the addiction epidemic. Over the next five decades, the industry’s leaders promised to rehabilitate the casualties of the drug culture even as incarceration rates for drug-related offenses climbed. In this history of addiction treatment, Claire D. Clark traces the political shift from the radical communitarianism of the 1960s to the conservatism of the Reagan era, uncovering the forgotten origins of today’s recovery movement.

Based on extensive interviews with drug-rehabilitation professionals and archival research, The Recovery Revolution locates the history of treatment activists’ influence on the development of American drug policy. Synanon, a controversial drug-treatment program launched in California in 1958, emphasized a community-based approach to rehabilitation. Its associates helped develop the therapeutic community (TC) model, which encouraged peer confrontation as a path to recovery. As TC treatment pioneers made mutual aid profitable, the model attracted powerful supporters and spread rapidly throughout the country. The TC approach was supported as part of the Nixon administration’s “law-and-order” policies, favored in the Reagan administration’s antidrug campaigns, and remained relevant amid the turbulent drug policies of the late twentieth and early twenty-first centuries. While many contemporary critics characterize American drug policy as simply the expression of moralizing conservatism or a mask for racial oppression, Clark recounts the complicated legacy of the “ex-addict” activists who turned drug treatment into both a product and a political symbol that promoted the impossible dream of a drug-free America.”

Claire Clark is an Assistant Professor of Behavioral Science at the University of Kentucky. She is secondarily appointed in the Department of History and associated with the Program for Bioethics. Clark further directs a National Endowment for the Humanities Summer Institute on Addition in American History. She graduated from Vassar College and was dual trained as an historian of medicine (PhD) and behavioral scientist (MPH) at Emory University.

For more information, visit the Columbia University Press website, available here.