Interview With Jesse Proudfoot

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

Jesse Proudfoot is an Assistant Professor in the Department of Sociology at Durham University. His research focuses on drug use among marginalized and racialized people, the politics of drug policy and treatment, and the relationship between addiction and structural violence.

What is your article “The Dreamwork of the Symptom: Reading Structural Racism and Family History in a Drug Addiction” about?

This article is about the relationship between oppressive social forces and illnesses like drug addiction. It’s common in medical anthropology to argue that seemingly individual illnesses need to be understood as shaped, and often produced, by social forces, but the precise ways that these forces produce illness is difficult to chart in concrete terms. In this article, I try to analyze this process, by looking at the case of one person I interviewed: Leon, an African American man from Chicago who had an addiction to crack cocaine. Drawing on psychoanalysis, and in particular, Freud’s idea of the dreamwork, I attempt to show how latent social forces like structural racism can find expression in symptoms such as drug addiction, but only through the mediation of other proximate layers—in Leon’s case, his complex relationship with his family and his own radical politics.

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

I’ve been interested in drug use and addiction since my PhD, which was an ethnographic study of homeless drug users in Vancouver’s Downtown Eastside. I charted their experiences as the neighbourhood underwent rapid changes due to progressive developments in drug policy, as well as gentrification. My earlier work was more concerned with the politics of harm reduction drug policy, but over the years, I’ve become more interested in the broader question of addiction and the subjective experience of people with problematic relationships to substances. I’m most interested in thinking about symptoms—like addiction—as sites of connection between the social, the political, and the subjective.

What drew you to this project?

This research grew out of an 18 month period of fieldwork I conducted in Chicago in 2012-13. I was working in a halfway house for people being released from prison who were struggling with drug addictions. I was struck by the diversity of people’s experiences of addiction, which ranged from what we might call acute self-medication, in order to deal with intolerable life circumstances, to much more complex, unconscious dynamics related to childhood trauma. Having written about these different forms of addiction in an earlier paper (‘Traumatic Landscapes’, 2019), I became interested in understanding what else we can read in addictions and the broader question of how to understand the relationship between politics and symptoms.

What was one of the most interesting findings?

The hook of this paper is that understanding the causes of your illness is not the same as treating it. Critical medical anthropology places a lot of emphasis on the demystification of symptoms, implicitly arguing that by uncovering the social causes of illnesses, we can alleviate them. Even though it now sounds obvious, I was struck during this research by the gap between demystification and therapeutics. My interlocutor Leon had a very well-developed political analysis of his addiction, grounded in critical political economy and anti-racism, and we talked about this often. But these insights failed him where he needed them most, in changing his own relationship to drugs. Making sense of this gap was what prompted me to think more deeply about how we approach the question of demystification.

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

I started running last year, which means I’m listening to a lot of podcasts. My current favorites are Know Your Enemy, which is a deep dive into American conservative thought for people on the Left, and Love is the Message by Tim Lawrence and Jeremy Gilbert, which is focused on dance music, counterculture, and collective joy—things I’ve spent a lot of time thinking about. The most recent novel I read was A Gate at the Stairs, by Lorrie Moore; a very funny and sad book about going to college, grief, and loss.

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

The demystification of illness is a complex business and our critical efforts must be attentive to the highly particular ways that people experience and embody those social forces that medical anthropologists are often interested in. As I hope to show in the article, this is essential not only to more accurately theorize illness, but also to help people with addictions to make sense of their lives and navigate their recoveries. Care must be ‘structurally competent’ in Jonathan Metzl and Helena Hansen’s terms, but also—in the spirit of the best traditions within psychoanalysis—grounded in the particularities of life histories.

Other places to connect:
Website

Interview With Hanne Apers

Posted by taylorshimizu

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

Hanne Apers, a female PhD candidate at the University of Antwerp’s Centre for Population, Family, and Health, specializes in mental health and migration. With a background in psychology and anthropology, she is currently completing her PhD-research on the explanatory models of mental health among East-African migrants in Belgium.

What is your article “Explanatory Models of (Mental) Health Among Sub-Saharan African Migrants in Belgium: A Qualitative Study of Healthcare Professionals’ Perceptions and Practices” about?

This study explores how mental health professionals in Belgium perceive the mental health understandings of their patients with a sub-Saharan African (SSA). 22 professionals were interviewed, including ten who also have a SSA migration background. The study explores three main aspects. Firstly, it examines how professionals perceive their SSA patients’ explanatory models of mental health. Secondly, it investigates the impact of these perceptions on their treatment approaches. Lastly, it considers the influence of professionals’ cultural backgrounds, comparing those with and without an SSA background.

The findings highlight noticeable differences in explanatory models, the main distinction was found in the beliefs about what causes mental health issues. Professionals’ understanding of SSA models affects their treatment practices, those familiar with SSA views faced fewer language and interpretation challenges. Non-migrant professionals emphasized cultural sensitivity and SSA-background professionals adopted an integrated approach. These findings contribute to discussions about what it means to be “culturally competent” in mental health care.

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

With a background in psychology and anthropology, my interest lies in exploring how different cultural views on mental health affect how people live, seek and prefer healthcare. As an anthropologist, I focus on qualitative research, favoring participatory, community-based methods to better understand the impact of cultural perspectives on healthcare dynamics.

What drew you to this project?

Numerous barriers and factors continue to hinder migrants’ access to healthcare. My aim was to contribute to lowering these barriers by comprehending the role of cultural understandings and illustrating how the organization of healthcare systems can be adapted to these differing understandings, and contribute to closing the treatment gap.

What was one of the most interesting findings?

The comparison between professionals with and without a similar migration background yielded intriguing insights, advocating for improved representation within healthcare systems.

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

The book ‘Crazy Like Us’ by Ethan Watters provides a compelling non-academic exploration of how global mental healthcare is shaped by a prevailing Global North perspective, sometimes with detrimental effects.

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

I hope to underscore the significance of recognizing cultural understandings and conceptualizations of health. It’s a crucial factor to consider if we aspire to develop and advocate for healthcare approaches that are truly inclusive.

Other places to connect:
Website
LinkedIn

Interview With Mary Hawk

Posted by taylorshimizu

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

Mary Hawk (DrPH) is the LSW professor and chair at the University of Pittsburgh School of Public Health, Department of Behavioral and Community Health Science. Dr. Hawk’s work includes the implementation and assessment of structural interventions to improve health outcomes for oppressed populations and the development of community-engaged approaches to optimize public health. She is co-founder of The Open Door, a harm reduction housing program created to improve health outcomes for chronically homeless people with HIV.

What is your article “Harm Reduction Principles in a Street Medicine Program: A Qualitative Study” about?

In this study we partnered with Operation Safety Net (OSN), a nonprofit that provides street medicine services to rough sleepers – people who are unhoused. We conducted qualitative interviews with OSN providers to pinpoint ways that street medicine differs from other kinds of healthcare and what elements of care were most helpful to patients. We learned this care is built on relational harm reduction, which centers the patient-provider relationship. Ways that harm reduction played out included meeting patients where there are (both emotionally and practically, in this case on the street), offering genuine concern and dignity to patients, and supporting patients them in non-judgmental ways were found to be important aspects of this work. We hope these findings help others who care for marginalized patients consider how they can engage them in care and bridge them to other healthcare services, and ultimately help expand the field of street medicine.

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

I worked in nonprofit settings for many years, mostly providing services to people with HIV (PWH) who experience oppression and marginalization. This community-based work is the foundation of my research. I’m interested in building evidence for community-driven approaches that advance health equity for historically excluded populations. All my work centers on harm reduction, especially as a relational approach to care, which considers ways that patient-provider relationships can improve care outcomes. At the moment, I am working on a National Institute of Mental Health (NIMH)-funded study that explores the impact of a harm reduction-based financial management intervention on adherence among unstably housed PWH, as well as a National Institute of Drug Abuse-funded study using mixed methods to investigate experiences of stigma in healthcare settings by PWH who use drugs.

What drew you to this project?

Operation Safety Net is an amazing organization. When we first started meeting with Dr. Jim Withers, who has made an immeasurable impact on rough sleepers and street medicine providers across the world, we had an “aha moment” and realized that an essential piece of his work seemed to be rooted in relational harm reduction. It was exciting to explore these ideas with OSN providers. At the core of relational harm reduction is the idea that all patients are worthy of respect and autonomy, and we really saw that play out with the OSN team.

What was one of the most interesting findings?

In our planning meetings with Dr. Withers and other OSN leadership we could hear the genuine care they have for their patients, but seeing this through the interview data was very compelling. But the loss and grief they experience when their patients die was also clear. We talk about burnout in healthcare, but don’t often think about that in terms of grief experienced by providers.

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

I’m right in the middle of “The Call,” an episode of This American Life that details an overdose prevention hotline, which is a great example of how we can show care for people who are too often stigmatized through harm reduction work. I’m also a diehard Survivor fan!

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

Humanism is at the heart of harm reduction approaches to care, including street medicine. Affording people dignity and genuine concern is the jumping off point for engaging anyone in care, but especially those who regularly experience trauma and systematic oppression. It can make all the difference to not only their experiences of care but also their retention in care and, ultimately, clinical outcomes.

Other places to connect:
Website
Twitter
LinkedIn
Instagram

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

Conference: American Society for Bioethics and the Humanities, Oct 19-22, 2017

Posted by sonya.petrakovitz

This week we are highlighting four sessions from the upcoming American Society for Bioethics and the Humanities Annual Conference in Kansas City, MO from October 19-22, 2017. The sessions are categorized under Religion/Culture/Social Sciences, and include topics interesting to scholars in multiple disciplines. For the full conference schedule, visit the ASBH 2017 meeting website here.

Panel Session: China’s Forced Organ Harvesting: A Central Test of Our Time

Thursday, Oct 19 – 1:30-2:30pm

With David Li, Yiyang Xia, and Grace Yin

A decade of research by international investigators has concluded that the Chinese party-state is systematically killing prisoners of conscience on demand to supply its vast organ transplant industry. In June 2016, the U.S. House of Representatives unanimously passed H.Res. 343, condemning the harvesting of organs from Falun Gong adherents and other prisoners of conscience in China.

Researchers examined hundreds of transplant hospitals in China and analyzed data about their capabilities, capacity, personnel strength, and potential patient groups from medical journals, media reports, official statements, web archives, and government policies and funds.

The research estimates that China now performs between 60,000 and 100,000 transplants per year–more than any other country in the world. Even based on government-imposed minimum requirements, China could have performed more than one million total transplants since 2000.

The official organ sources–death row prisoners and voluntary donors–account for only a small fraction of the total volume. The victims are primarily Falun Gong meditators killed through organ extraction outside of judicial process as part of the Communist Party’s campaign to eradicate the group.

The issue of forced organ harvesting presents an opportunity and an obligation to bring medical and academic institutions to the center of bioethics. Presenters will articulate with the audience concrete actions to prevent the complicity of American institutions and individuals, including providing training, equipment, recognition, collaboration, and organ tourism to Chinese institutions that are participating in this crime. Comprehension of the issue helps institutions and individuals make informed choices and uphold social responsibility.

Panel Session: Pathways to Convergence: Sharing a Process that Aimed to Examine the Diverse Perspectives of Catholics on Advance Care Planning and Palliative Care in the United States

Thursday, Oct 19 – 2:45-3:45pm

With Robert Barnet MA MD, John Carney MEd, Matthew Pjecha MSPP, and Carol Taylor MSN PhD RN

Pew Charitable Trusts recently funded a project to examine views among Catholics in the U.S. regarding end-of-life, palliative care and advance care planning. Center for Practical Bioethics (CPB) served as coordinator for the project. A six-member steering group representing ecclesial, Catholic Health, and ethical interests, along with CPB (a secular organization) invited three groups of eight Catholics from different disciplines and perspectives to capture conservative and progressive themes within American society and among practice settings. Roles and responsibilities within those realms were prominently featured in deliberations with goal of clarifying areas of divergence, convergence and possible paths forward. The groups examined: – Social responsibility derived from tradition (how the Church presents itself and speaks in the public square and what informs this presence) – Covenant and contract (roles of free and informed consent in advance care planning and decision-making between patients and providers) – Shared decision making (Church teaching that informs specific decisions faced in goals of care conversations and interdisciplinary care planning for palliative care patients)Identified as Pathways to Convergence the groups aspired to identify common values and principles and report on the results following a convening. Presenters will explore how ethicists can use the processes, methods and findings of this group when workings with patients for whom faith tradition may play an important role and among providers, and others who share different perspectives on end of life to facilitate optimal advance care planning and palliative care.

Paper Session: Religion, Culture, and Social Sciences Paper Session 1

Thursday, Oct 19 – 4:00-5:00pm

Creating Compliance: Using Games to Engage Patients in Medical Management

by Kristel Clayville

This presentation offers a method for increasing compliance among transplant patients. The recommendations presented are from non-medical clinical observation from a chaplain who deals with the day-to-day coping skills of transplant patients. The case studied focuses on the emotional aspects of compliance, and the attendant interpretation and recommendations focus on the social, emotional, and spiritual aspects of dealing with the existential difficulties of undergoing a solid organ transplant. Ultimately, the recommendations are for presenting medical compliance as a game that patients play rather than as a set of medical practices that sustain life. Thinking in terms of games not only helps the patient’s motivation, but it also offers the family and support network a language with which to engage the patient and help with the practices of compliance.

The Ethics of Influence: Celebrity Physicians and Social Media

by Patrick Herron

Growth of social media has not only changed how individuals interact socially, but in how we engage with professionals too. Recognition of a physician’s social media “influence” is based on her/his ability to affect other people’s thinking. The greater the influence, the more appeal that individual has to companies or other individuals who might want to promote an idea or sell a product. Celebrity actors/athletes are often seen as prime influencers with regards to advertising campaigns, (i.e. “Got milk?” and “Milk: it does a body good”) to increase sales.

Celebrity physicians such as Dr. Mehmet Oz have used influence to promote health products and interventions, which raised considerable debate as to whether there were lapses in ethical and professional judgment. Not all physicians will have the platform of a Dr. Oz, but social media has created ample opportunities for many lesser known physicians and trainees to leverage their own professional expertise and growing social media prominence to become influencers. Such financial partnerships raise questions about conflicts of interest, professionalism and potential violations of an ethical duty of care.

The impact of social media on consumer healthcare decision making along with the dependence by consumers on their friends and families for healthcare product reviews (often shared via social media) has dramatically changed marketing. Consumer confidence and increased reliance on the opinions of physicians they follow via social media accounts can have a detrimental affect on the patient-physician relationship that consumers have with their actual health care provider.

Make Aging Great Again: Imagining a YUGE Lifespan

by Leah Fowler

The new era of longevity research seeks extended healthy life, with hoped-for interventions that would slow the aging process so that one year of clock time is matched by less than one year of biological time. Infirmities of old age would compress into a short period at the end of life—thereby increasing the ‘health span’. The benefit: living long and living well. Embedded in longevity discourse is humanity’s oldest and most pervasive wish: defying death. Slowing the process of aging, it is hoped, will lead to treatments to reverse it.

Social arenas and actors at the center of longevity are grounded in big data, big investment, and a breathtaking sense that “the person who is born today will live to 200.” A prominent longevity researcher says, “It is ageist and morally repugnant to not treat aging as a disease that needs a cure.” These expectations, fueled by aging populations, are rooted in narratives that render the possible futures of long, healthy lives as inevitable and real today. Bringing the future into the present—conveying hope and fear as moral vectors— introduces an imperative to pursue the extension of the life- and health spans as a matter of course, and devalues alternatives as non-progressive or even immoral. This paper presents a qualitative analysis of longevity stakeholders discussing the moral imperative to extend human life and free of the ravages of aging. Their narratives illustrate future social imaginaries that are central to the movement and spur us to take action today.

Paper Session: Religion, Culture, and Social Sciences Paper Session 2

Sunday, Oct 22 – 9:15-10:45am

Religion Matters: A Critical Response to Daniel Weinstock’s Appraisal of Conscientious Refusal

by Nicholas Brown

Daniel Weinstock has recently argued that it is necessary to make a distinction between freedom of conscience and freedom of religion when evaluating questions of conscientious refusal. Weinstock holds a right to refusal to care on the grounds of conscience enjoys a more privileged status than refusals made on religious convictions inasmuch as he judges religious refusals to be non-essential to the flourishing of a robust democratic ethos, and because he finds religious objections to lack a sufficient epistemological and ethical rationality that is publicly “reasonable.” The purpose of this paper is to offer a response that is both critical and sympathetic. Toward that end my argument is as follows: First, I will critically evaluate the underlying epistemological assumptions undergirding Weinstock’s privileging of conscientious over religious refusals to care. More specifically I will draw upon the philosophical work of Nancey Murphy and Michael Polyani to show not only why Weinstock’s account of reasonability is inadequate, but also why a religious ratio is just as publicly accessible as a non-confessional one. Next, I will draw upon Romand Cole’s political theory to demonstrate why religious perspectives are not only vital to the flourishing of a democratic ethos, but are so precisely because they help inculcate the critical mode of conscience that Weinstock endorses. Finally, I conclude by suggesting that Lisa Sowle Cahill’s articulation of theology as a participatory mode of discourse offers a more compelling basis upon which to adjudicate the ethical tensions entailed in conscientious refusal that Weinstock rightly identifies.

The Church Amendment Reconsidered: Lost Assumptions of the First Federal Healthcare Conscience Clause

by Ronit Stahl

In the wake of Roe v. Wade (1973), Congress passed the Church Amendment, which allows doctors, nurses, and hospitals to refuse to perform abortions or sterilizations on the basis of religious or moral convictions. As the foundation of subsequent federal and state conscience clauses, the Church Amendment operates as a powerful tool that enables healthcare providers and institutions to opt out of providing—and thereby restrict access to—contested medical interventions, typically in reproductive, end-of-life, and LGBT healthcare. Yet the legislative history of the Church Amendment offers a more complicated and nuanced set of assumptions about the intended effects and implementation of the nation’s first healthcare conscience clause. This talk will discuss the presumptions about access, disclosure, scope, and impact embedded in the Church Amendment and consider the value of a countervailing narrative about conscience clauses in an era of expanding conscience legislation.

Hinduism and Bioethics: Some Basics and Some Applications

by Deepak Sarma

With an increasing number of patients with Hindu heritage and background, it is imperative that the bioethics community begins better versed in germane issues pertinent to Hindus. What, for example, is the Hindu position on brain death and organ transplantation? What sorts of neurogenomic treatments and interventions are possible given the Hindu view of the self? How do these perspectives agree, or conflict with prevailing discourses in bioethics? Since Hindus makeup only a small population of patients they are further from the ‘center’ and from most patients. Healthcare providers, in this connection, will need to expand their knowledge of those whose beliefs are not at the center.