Interview with Eugene Raikhel

As part of our ongoing content, we feature authors who have published in Culture, Medicine, and Psychiatry.

Today, we are excited to bring you our interview with Eugene Raikhel!

What is the article “What Crisis? Competing Narratives of Mental Health in US Higher Education “about?

The article draws on interviews that I conducted with mental health professionals who work with college students as part of a broader project on college mental health. Over the past few years we’ve collectively heard a lot about the “college mental health crisis” in popular discourse. In this article, I argue that mental health professionals have a range of very nuanced perspectives on the idea of a “college mental health crisis” and I trace five distinct ways in which they frame and understand the problem. Some of these framings stand in tension to one another, while others complement one another.

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

I am a cultural, medical, and psychological anthropologist and an Associate Professor in the Department of Comparative Human Development at the University of Chicago. My research interests generally cluster around what philosopher Ian Hacking has called “looping effects” – the multiple ways in which forms of knowledge, particularly in the domain of psychiatry and mental health – come to shape the lives and actions of people who live under their classifications, and how these actions in turn come to transform expert knowledge. I’ve looked at such issues in a historical ethnography of addiction medicine in post-Soviet Russia, and I’m currently examining them in a study which asks how ideas and enactments of mental health and illness are transforming in higher education settings.

What drew you to this project?

A number of years ago, while teaching a course about culture and mental health, I noticed that students seemed to be speaking about their own experiences with mental illness conditions in ways that seemed novel to me. These certainly were not the conversations that I remembered from my own college experiences in the 1990s. There was more disclosure, but beyond that, more identification with diagnoses, and generally more complex engagement with the issues raised by labels, medications, talk therapy, and more. It seemed that something in the culture at large was changing and this peaked my ethnographic interest. The broader study that I’m working on, tentatively titled “Degrees of Distress: College and the Transformation of Mental Health,” emerged from these early observations.

What was one of the most interesting findings?

We tend to think of medicalization or psychiatrization as processes being driven at least in part by professionals working to expand their jurisdictions. According to this logic, you would think that the psy professionals involved in college mental health would be always trying to attract more students to the counseling center and place more types of conditions under the framework of what they properly address. And while this is certainly the case to some degree, I found that many mental health professionals working with college students, and particularly directors of counseling centers, were both contesting the medicalization of mental health and arguing for a way of addressing mental health issues which would use more of the whole campus. Part of this is because many counseling centers have found themselves struggling to address the demand for services for many years now, and people are increasingly thinking of how to distribute various forms of care throughout a college or university. But it is also the case that many counselors want to maintain a space for interacting with students around problems which are not medicalized from the start; rather than the aim of therapy being symptom reduction, they want students to be able to make meaning out of experiences which have challenged them. So there’s a kind of active resistance to the medicalization of mental health among many of the professionals which was very interesting to find.

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

I’m reading Klara and the Sun by Kazuo Ishiguro, a novel told from the point of view of a humanoid robot with artificial intelligence. Given that my project has gotten me paying attention to the ways that some young people are increasingly turning to AI for help with mental health issues, as well as for various forms of companionship, this book has been great to think with.

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

Simply that it is important to not reduce the problem of college mental health to individual psychopathology. Such a framing also assumes that the only intervention which needs to be made is at the individual level – providing more access to therapy and medication – and while these are important tools, many counselors clearly agree that they are not adequate to addressing this problem “upstream”. At the same time, it is also the case that these same counselors and counseling center directors don’t usually have the tools to address upstream and structural causes.

Interview with Amand Führer and Julia Vorhölter

Posted by michellezernick

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

Today, we are excited to bring you our interview with Amand Führer and Julia Vorhölter!

Julia Vorhölter photographed by Jonathan von Koseritz.

What is the motivation for republishing the article “The Rebel Body: The Subversive Meanings of Illness “?

Amand: In many ways, it is a foundational document for Liberation Medicine, even though it does not mention the term. Also, it raises questions that are still relevant today and speak especially to debates taking place in social medicine, like the need for better structural competency for physicians.

Julia: In 2024, when we were organizing the workshop on which this Special Issue is based, I reread ‘Death without Weeping’ – Nancy Scheper-Hughes’ seminal monograph on her work in Brazil. And I thought ‘wow, there is so much in here, so much ethnographic detail combined with a powerful voice of analysis and political critique; anthropologists today don’t write books like that – with more than 600 pages – anymore’. Seth Holmes suggested we also read the ‘Rebel Body’ and when I did I had a very similar reaction. To be honest, I was surprised how well the article spoke to current issues and debates despite having been written in the early 90s. I think in our focus on contemporary scholarship and current trends and turns, we sometimes tend to forget the work of our foremothers (and -fathers).

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

Amand: My professional identity is a bit situation-dependent: Most of the time I see myself as a social medicine researcher, but I also have a background in social anthropology and medicine, and I work as a psychotherapist as a side hustle. My research gravitates around the topic of health equity and its mechanisms – e.g. why are poor children in Germany sicker than rich children, or how does living in shelters affect the health of refugees?

Hereby, I am most interested in dialog between empirical research and theory development, to improve our understanding of the mechanisms that connect social inequities to poor health.

Julia: Over the last few years, I have worked on three research projects – on psychotherapy in Uganda; on sleep, sleeplessness, and sleep medicine in Germany; and on the digitalization of health and elderly care in the former coal-mining region of Saxony-Anhalt – all of which are situated in the field of psychological, medical, and political anthropology. My work has centred on three overarching questions: How do understandings of and approaches to care change in relationship to emerging technologies, new forms of knowledge, and shifting economic and political orders? How do people – those affected and those trying to offer professional support – struggle with moments of crisis in which they are confronted with the limits of their own, or another person’s, body, mind, and agency? And how do they try to instigate positive change and imagine new futures despite their experiences of past injustices, broken body-minds, and collapsing life worlds?

What drew you to this project?

Amand: I’ve been talking about the social determination of health with medical students for many semesters – how the circumstances under which our patients live shape their health and, rather strongly, dictate if they can live healthy long lives, or sick and short ones. In such discussions, one problem that always comes up is that there are many fragments of theory used in social medicine, but students are yearning for a more comprehensive framework that provides some sort of bigger narrative on equity-oriented health. A second problem is that in routine medical training students almost never encounter examples of what a medicine, that takes the structural forces shaping health seriously, could look like in practice. What does it mean for medical students and physicians to make a preferential option for the poor?

With Liberation Medicine, I had the gut feeling that it might have this function: Provide a framework that is both theoretically grounded and practically applicable.

Julia: I think right from the start, our project was motivated by the idea of bringing together social scientists with medical students, scholars, and practitioners. And like Amand said, the concept of Liberation Medicine seemed to really speak to a broad range of people from different disciplines and across the theory-practice divide. Maybe one reason is that the concept is both critical, but also hopeful. Much of contemporary medical anthropology is ‘dark anthropology’ (to use Ortner’s 2016 term); but the idea of Liberation Medicine, at its core, is a hopeful one, a ‘concrete utopia’ as we argue in our introduction. In the ‘Rebel Body’, Nancy Scheper-Hughes argues that suffering, when politicized and heard rather than medicalized and silenced, can be a powerful driver of change, but that patients, doctors and critical observers need to work together to achieve this.

What was one of the most interesting findings?

Amand: In the workshop that was the basis of the special issue, I was impressed that the term Liberation Medicine created a strong pull for people from different disciplines: Medical anthropology, social medicine, clinical medicine, health activism and other fields. Also, it spoke to students as well as early career scientists and more established researchers alike. As Julia said, it looked like Liberation Medicine can be a uniting banner for various perspectives that want to engage medicine as a tool for social change.

Julia: I was struck by the creativity with which the workshop participants and the authors in our Special Issue put the concept of ‘Liberation Medicine’ to use. And I liked the powerful ethnographic stories it inspired – about a couple from a marginalized setting in India seeking hospital care (Dasgupta), about medical activists in Germany (Mair), about those wounded in political protests in France (Jacob Pinto), about doctors trying to provide meaningful care despite a crumbling health system in Spain (Aragon Martin) and about two convicts doing mental healthcare work in an LA prison (Bourgois). In all those stories, the authors see solidarity amidst crisis, suffering, and injustice.

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

Amand: I have just finished reading a book by bell hooks (Teaching to Transgress). It crossed my path when one of my students asked me if I have it (shout out to Larissa!), which I didn’t. But then, the title sounded so interesting that I bought it and read it in one go.

Julia: Over the semester break, I read Angela Garcia’s ‘The way that leads among the lost’, which I found deeply moving and have been thinking about a lot since. At the moment, I am reading Octavia Butler’s ‘Kindred; it’s a profound reflection on the possibilities and limits of individual agency in systems of oppression.

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

Amand: For health care providers: Cultivate an openness to understand illness as a form of protest, as a way of denying to continue under these circumstances; and find ways to responsibly answer to this protest.

Julia: For medical anthropologists (and other social scientists): tune your attention to more-than-suffering and violence and be open to an attitude of ‘more-than-critique’ when analyzing help-seekers, help-providers, and the politics and forms of care that (can) unfold amongst and between them, in the medical realm (and beyond).

Interview with Alexander Brandt Ryborg Jønsson, Elizabeth Xiao-An Li and Anne Mia Steno

Posted by michellezernick

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

Today, we are excited to bring you our interview with Mia, Elizabeth & Alex!

What is the article “Enacted Restoration of Selfhood: A Kierkegaardian Perspective on Self-harm Among People with Mental Illness” about?

The article is an exploration of the lived experiences of individuals engaging in non-suicidal self-harm and shows how self-harm is not only the experiential nexus of a complex relationship between the body and the world but also a mechanism for overcoming the self. Whereas self-harm within the context of mental illnesses has traditionally been researched and understood as symptomatic behavior, our contention is that self-harm can be described through the lens of ‘enacted selfhood’ as an analytical framework inspired by Søren Kierkegaard’s existential thought for shedding light on what more is at stake in self-harm among individuals living with mental illness.

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

Alex: I’m a social anthropologist with a focus on critical analysis of mental health and health services, particularly overuse and overdiagnosis. My work examines how diagnostic categories, practices, and technologies are produced and negotiated, and how they shape lived experiences, sustain promissory visions of biomedicine and generate broader questions of inequality and care.

Anne Mia: I’m a social anthropologist working within social psychiatry and welfare institutions. My research focuses on people living at the margins of welfare systems, attending to experiences of loneliness, not belonging, and everyday life under institutional conditions. Grounded in phenomenological approaches to the body, I explore how lives are shaped through movements between spaces, relations, and forms of care. Methodologically, I work ethnographically and with multisensory approaches to make present forms of experience that are often rendered difficult to articulate, asking how they are navigated, resisted, and reworked in practice.

Elizabeth: I’m a philosopher of religion and a Kierkegaard scholar, with particular interest in his concept of existence and critiques of systematic philosophy, the problems of conceptuality, and the relation between religious faith and reason as well as the development of existential thought more generally in 19^th and 20^th century European philosophy and theology.

What drew you to this project?

This article is a collaborative and interdisciplinary project between the three of us, but it was developed over different stages. Alex and Anne Mia conducted different field works on two different projects, both centering on lived experiences with mental illness. We’ve known each other since our university days and often discuss theoretical or empirical challenges. We both became curious when we noticed how conversations with interlocutors about their experience and reflections on non-suicidal self-harm did not seem to reflect the way in which this phenomenon has traditionally/predominantly been treated in existing research. Here self-harm remains marginalized both analytically and empirically as it is viewed as a mere symptom among individuals living with mental illness or “call for help”. However, what we, Alex and Anne Mia, experienced in fieldwork, showed that there was something more at stake in the question of self-harm: It took up a lot of space in conversations with individuals who self harmed, who had profound and extensive reflections on the way they experienced this, thought about it, and enacted it with many expressing it to be an act of deep existential import.

Alex later invited Elizabeth to collaborate, after hearing her speak about Søren Kierkegaard at the Young Academy of the Danish Royal Society, which we are both fellows of. Upon discussing the project, it became clear to us that Kierkegaard’s concept of existence and selfhood and his proto-phenomenological and existential approach could offer a theoretical framework that could encompass/shed light on the individuality, existential complexities and the many ambiguous and paradoxical ways self-harm was reflected on and described by individuals in their lived experience of engaging in self-harm.

The article is thus the result of a discovering deeper and mutually illuminating connections between our research interests and bringing these together in this joint interdisciplinary effort.

What was one of the most interesting findings?

That self-harm is not merely a call for help or a means of translating or displacing psychological pain into physical sensation; rather, it may be understood as an example of what we term “enacted selfhood.” While the linguistic and discursive dimensions are often foregrounded within social recovery frameworks, this research underscores the importance of attending to concrete, embodied experience. The body, too, articulates meaning: self-harm constitutes a form of expression to which we ought to remain attentively and analytically responsive.

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

Alex: I have been reading Glenn Bech’s Jeg anerkender ikke længere jeres autoritet (I No Longer Recognize Your Authority) which poetically explores experiences of societal inequality. I am the first in my family to even graduate from high school and his words really reflect my own experiences in childhood, but also broaden my understanding of the deep humanity present in the most difficult lives and fates among my interlocutors. I’ve been listening to Mahler’s “Symphony No. 3”, which I’ll be going to hear performed by Tivoli Copenhagen Phil & Odense Symphony Orchestra next month (and Elizabeth will join me!) but I generally like all kinds of music and am a very dedicated euphonium player in Copenhagen Brass Band.

Anne Mia: I am currently reading The Museum of Innocence by Orhan Pamuk, which explores the relationship between the affluent Kemal and the less privileged Füsun, and how Kemal assembles a collection of objects, such as one hundred cigarette butts, that come to narrate the story of their love. The novel simultaneously functions as a key to a physical museum, blurring the boundaries between fiction, materiality, and exhibition. Reading this work serves in part as inspiration for a current research grant application, as I am particularly interested in modes of dissemination and in how anthropological inquiry might intersect with aesthetics and literary form.

I have been listening extensively to Bach lately; and, as a mother, I have, perhaps less voluntarily, been accompanying my child’s engagement with Melodi Grand Prix, Denmark’s children’s version of Eurovision.

Elizabeth: I recently finished Ben Lerner’s new novel Transcription and just started re-reading Plato’s Dialogues. The next work of fiction I’ll be picking up is Anne Mia’s YA novel Akio from 2021, which very presciently explores a romantic relationship with an AI. As a Kierkegaard scholar, I’m endlessly fascinated with the struggles we humans have in communicating our thoughts and inner lives, and the ways in which our technology and media for communication can hinder and complicate our relationships with and understanding of ourselves and others. I keep coming back to Wagner’s Tristan und Isolde, but I have also been listening to a lot of David Bowie and Wet Leg these past weeks. In between comfort-(re)watching The Office and Gilmore Girls, my most recent trip to the cinema was to see Kristoffer Borgli’s The Drama.

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

Not to dismiss or take for granted certain phenomena, behaviors or actions, but recognize the limits of categorization: As our exploration of self-harm shows it is necessary to take into account the individual and the particular context, which at the same time is not something we can simply understand and explain once and for all. As Kierkegaard underlines to try to turn human experience into circumscribed, universal concepts results in dissolving the reality we are attempting to grasp, because our concrete embodied existence as individuals is in movement.

Interview with Augustus Osborne

Posted by michellezernick

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

What is the article “Embracing Pluralism: Rethinking Western Psychiatric Models for Equitable Global Mental Health” about?

This article is fundamentally a challenge to one of global health’s most comfortable assumptions: that what works in Boston or London will work in Freetown or Kampala, provided we translate it carefully enough. The global mental health movement has done genuinely important work in drawing attention to the enormous burden of mental illness in low- and middle-income countries up to 85% of people with mental health conditions in these settings receive no treatment at all. But in its urgency to close that treatment gap, the movement has largely exported Western psychiatric frameworks wholesale: the DSM diagnostic categories, pharmaceutical-centred treatment protocols, and individual psychotherapy as the gold standard of care.

My article argues that this approach carries real risks that are too often ignored. It can produce cultural mismatch where diagnostic tools built on Euro-American concepts of depression and anxiety fail to capture how distress is experienced and expressed in other societies. It can medicalise what is fundamentally social suffering, framing poverty, displacement, and structural injustice as individual disorders amenable to a prescription. And it can marginalise or displace indigenous healing systems traditional practitioners, religious leaders, community elders that communities trust and turn to.

The paper is not an argument against biomedical psychiatry. It is an argument for pluralism: a framework that values multiple healing traditions as equally legitimate, prioritises cultural adaptation and local leadership, and insists that equity not just coverage must be the measure of success. I draw on evidence from Zimbabwe’s Friendship Bench, community-based programmes in India and Pakistan, and hybrid models from Nepal and Uganda to show that locally grounded approaches are not second-best alternatives they are often more effective, more sustainable, and more meaningful to the people they serve.

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

I am a public health researcher based in Freetown, Sierra Leone, where I was born and trained. I hold an MSc in Public Health and a BSc in Biological Sciences from Njala University, and I have spent the past decade trying to understand and generate evidence about the structural forces that shape health and illness in Sierra Leone and across sub-Saharan Africa.

My research spans a wide range of topics: maternal and child health, health systems strengthening, infectious disease, health equity, and increasingly, the intersection of digital health and social determinants of wellbeing. I have authored and co-authored over 140 peer-reviewed publications, and I used to teach Epidemiology and Biostatistics at Njala

University, where I tried to pass on not just statistical methods but a way of thinking about evidence who produces it, who it serves, and whose experiences it tends to miss.

What connects all of my work is a preoccupation with equity with understanding why health outcomes are so unequally distributed, and with generating the kind of evidence that can actually move policy in the right direction. I use a range of tools ArcGIS for spatial analysis, machine learning for predictive modelling, NVivo and MAXQDA for qualitative work but the driving question is always the same: who is being left behind, and why?

Mental health sits at a particularly important intersection of these concerns. In Sierra Leone, the legacy of a decade-long civil war, the Ebola epidemic, and chronic poverty has created an enormous burden of psychological distress yet mental health services remain desperately under-resourced, and the frameworks imported to address the gap do not always fit the realities of the people they are meant to serve.

What drew you to this project?

Honestly, it was the gap between what I observed in practice and what the global mental health literature was telling me should work.

Working in Sierra Leone first as a surveillance officer during the Ebola outbreak, then in health systems research I repeatedly encountered situations where people in psychological distress were navigating between multiple systems of care simultaneously: visiting a biomedical clinic, consulting a traditional healer, seeking counsel from a religious leader. This was not confusion or ignorance. It was a rational response to a plural reality, where different systems offered different things and no single framework captured the full picture of suffering or healing.

Yet the global mental health literature I was reading largely treated this pluralism as a problem to be overcome, a sign of inadequate access to proper care rather than as a resource to be understood and built upon. I found that framing both empirically questionable and, frankly, troubling in its assumptions about whose knowledge counts.

I was also struck by the growing body of evidence from programmes like Zimbabwe’s Friendship Bench, which showed that community-embedded, culturally resonant interventions could achieve outcomes comparable to or better than imported Western protocols. That evidence deserved a more prominent place in the conversation about how global mental health should be organized and funded. Writing this paper was my attempt to make that argument systematically drawing together the critique, the evidence, and a concrete set of recommendations in a way that might be useful to researchers, practitioners, and policymakers working in this space.

What was one of the most interesting findings?

The finding that most stayed with me and that I think has the broadest implications is the evidence around stigma. The dominant narrative in global mental health has long been that the biomedical model reduces stigma by framing mental illness as a brain disease rather than a moral failing or spiritual affliction. The logic is intuitive: if depression is a chemical imbalance, not a character flaw, people should be less blamed for it.

But the evidence I reviewed tells a more complicated story. In several settings, the introduction of Western psychiatric labels increased stigma because these diagnoses were experienced as foreign, permanent, and frightening in ways that local idioms of distress were not. In rural China, medicalizing depression led to greater social distancing, not less. In Sri Lanka, Western diagnostic terms for schizophrenia were associated with new forms of social exclusion. The assumption that biomedical framing is universally destigmatizing turns out to be empirically unfounded and it is an assumption that has shaped enormous amounts of global mental health investment.

This matters because it illustrates a broader point: the risks of exporting Western models are not just theoretical. They play out in real people’s lives, in communities where the introduction of a foreign framework can disrupt existing social networks, undermine indigenous coping strategies, and create new forms of harm even while trying to help. That is a finding that should give the global mental health movement serious pause.

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

I am currently reading The Wretched of the Earth by Frantz Fanon which feels more relevant than ever to the questions this paper raises about knowledge, power, and whose frameworks get to count as universal. Fanon’s analysis of colonial psychiatry is remarkably prescient, and I find myself returning to it as a grounding text for thinking about decolonial approaches to global health.

In terms of listening, I have been following the Global Health with Greg Martin podcast, which does a good job of bringing together researchers and practitioners from the Global South in conversations that do not always make it into mainstream journals. There is something valuable about hearing researchers from Sierra Leone, Uganda, and Nepal speak in their own voices about the challenges and opportunities in their contexts.

And I have been watching with great interest and some anxiety about the ongoing debates about artificial intelligence in healthcare. My own research has moved increasingly into machine learning applications for public health, and the questions about bias, equity, and whose data trains the models feel very continuous with the questions I am raising in this paper about whose knowledge shapes global mental health frameworks.

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

The one thing I most want readers to take away is this: pluralism is not a compromise it is a superior framework.

I am aware that pluralism can sound like a polite way of saying “let’s include everyone and not make hard choices.” That is not what I mean. I mean something more specific and more demanding: that the most effective, most equitable, and most sustainable approaches to global mental health are those that genuinely value multiple healing traditions as legitimate on their own terms not as supplements to biomedical care, not as cultural window-dressing on Western protocols, but as systems of knowledge and practice that have evolved to address human suffering in specific social and historical contexts.

The practical implication is that funders, policymakers, and researchers need to stop treating the question “how do we scale up Western psychiatric models in low-income countries?” as the primary question of global mental health. The primary question should be: “How do we build mental health systems that are meaningful, accessible, and effective for the specific communities they serve?” Sometimes the answer will involve biomedical psychiatry. Often it will involve traditional healers, community volunteers, religious leaders, and social interventions that address the structural roots of distress. Almost always it will require local leadership, genuine community co-design, and the humility to recognize that the Global North does not have a monopoly on wisdom about how human beings heal.

That shift from export to partnership, from uniformity to pluralism is the action point I hope this paper contributes to.

Interview With Shai Satran

Posted by michellezernick

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

Shai Satran is a Postdoc at MIT in the program of Science, Technology, and Society. His research lies at the intersection of Anthropology, Psychology and Technology. His dissertation, Couch to Keyboard: Patients, Labor and Data in the Age of Psychotherapy Automation, is an ethnography of computerized therapy, its development and its dissemination in Israel’s public mental health system. He is also trained as a psychotherapist.

What is your article “From Craft to Labor: How Automation is Transforming the Practice of Psychotherapy“ about?

My article is about a novel form of therapist-assisted computerized therapy and how it is changing the ways in which therapists do psychotherapy. I argue that computerized therapy introduces what is a major change to how psychotherapy is conducted, namely, that it constitutes a shift in psychotherapy’s status as a profession, from craft to labor. I use these terms in the Marxist sense, but basically what I mean to say is that therapists today usually still retain a very high level of control over the content and form of their therapeutic work, and that this is now changing in significant ways. I detail how computerized psychotherapy’s ‘division of labor’ is minimizing the control and influence of the therapists conducting therapy, while introducing a new and powerful level of management, and potentially degrading therapists’ status – but, and this is important, that it is also potentially of real value for patients.

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

I was trained as a psychotherapist in Israel, and as a trainee I began practicing therapy. At a certain point I understood that I might find therapy more interesting to think about than to actually do, and decided to pursue a PhD through which I would be able to think deeply about issues related to psychotherapy. I think psychotherapy is fascinating and in my eyes still mysterious; how does it work? What is actually happening there? Beyond psychotherapy I have an interest in technology and its seemingly ever-growing role in our everyday life, dreams and fears.

What drew you to this project?

In one of the monthly seminars in the public clinic in which I was practicing, a psychology professor came to introduce a digital ‘gamified’ therapeutic app he developed as a supplement to face-to-face therapy. He presented the app, and a plethora of accompanying empirical evidence of its efficacy. After the lecture was over and the professor left, the head psychologist asked who would like to use the app with their patients. Over thirty therapists in the room, and not one raised their hand. I remember thinking “well, that’s interesting!”

What was one of the most interesting findings?

One thing that I found interesting, and this really came from ‘the field’ and not at all something that I expected to encounter, was the disparity in the experiences of computerized therapy between patients and therapists. While patients’ reactions were mixed of course, many of them describe the course of online therapy as a very positive, and beneficial, experience. Therapists, on the other hand, recognized the utility of this therapy but invariably described the experience as unfulfilling, and emphasized how they do not want to continue working as online therapists. I have come to realize that this gap between the experience of ‘service providers’ and ‘customers’ has become exceedingly common (e.g. Amaozn), and is in itself indicative of neoliberal trends and the professional shift I describe in the article.

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

Unfortunately, I barely read for fun anymore! My next research project is a history of computer scientist Joseph Weizenbaum and his ELIZA computer program (1966) which famously impersonated a Rogerian (Carl Rogers’ client centered therapy) psychotherapist. So, I am reading through some of the seminal early texts of artificial intelligence; the things I imagine Weizenbaum must have been reading back then…

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

That it would be a mistake to blindly vilify technology while romanticizing face to face interactions. I can understand, and even relate to, a certain disdain for the very idea of automating psychotherapy, but I think its worth remembering two things: First, there are real world constraints to providing quality care at scale and that different things work for different people. While many people may need a human relationship and a face to face encounter to experience positive change, others might actually do well with less than that. Second, not all in-person therapy is good therapy. Some of the patients I met during my research actually arrived at computerized therapy in order to avoid a face to face encounter with a therapist. It is painful but important to acknowledge that the very worst things that happen in therapy (malpractice, emotional abuse or sexual assault), even if they are rare, happen in face to face therapy.

Other places to connect:

2025 Early Career Development Award Winner

Posted by michellezernick

Congratulations to our 2025 Early Career Development Award winner, Harry Whittle, for his piece, Ronaldo on the Clapham Omnibus: Complex Recoveries in Complex Psychosis.

Harry is a psychiatrist and anthropologist in training. He is currently a doctoral researcher in the Department of Anthropology and Sociology at SOAS University of London, where he is part of the Centre for Anthropology and Mental Health Research in Action (CAMHRA). Harry’s research focuses on ideas of recovery, rehabilitation, and community in mental health and mental health services, particularly in relation to people living with more complex, severe, and enduring forms of psychosis.

When asked about his article, Harry said:

In the article, I think critically about recovery in psychosis. I ask how it complicates our understanding of recovery if we consider the experiences of people with the most complex forms of psychosis, who have inadvertently been excluded from much debate on this topic. Drawing on six months of ethnography on an inpatient psychiatric rehabilitation unit, the article centres around a man I call Shepherd, whose journey to becoming a more confident, calmer, happier person was characterised by caution, masking, social withdrawal, and scepticism towards hope. These are embodied practices that seem incompatible with many portraits of recovery in the literature. Yet, here, they enabled—or even constituted—Shepherd’s recovery. The social complexities and ambivalences in his story reflect not only how complex recovery can be, but also how complex people’s relationships with mental health services can be. During his lengthy psychiatric admission, the coercive structures of the hospital were difficult to separate from the time, space, and relative safety they afforded Shepherd, which allowed him to figure out his recovery for himself. If we oversimplify recovery by missing people like Shepherd, we risk structurally undermining the interventions—like inpatient rehabilitation here—that may best support them to live well.

Congratulations, well earned!

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Interview With Scott D Stonington

Posted by michellezernick

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

Scott D Stonington, Associate Professor of Anthropology and Internal Medicine, University of Michigan Ann Arbor

Scott Stonington is a cultural anthropologist and internal medicine physician. His first book, The Spirit Ambulance, won awards from multiple academic societies for ethnographic writing. His two major current projects address affect in clinical practice in the U.S. and pain management in Thailand.

What is your article “Hallucination’: Hospital Ecologies in COVID’s Epistemic Instability“about?

In early COVID in the hospital, clinicians were driven into scientific and data-hungry frenzy trying to understand the virus, making their clinical practice very unstable, changing dozens of times daily in response to tweets, texts and news articles. The article is a case study on the dependence of clinical knowledge and practice on context, in contrast to the usual assumption that it is the “view from nowhere.”

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

I practice hospital and primary care medicine, which makes me constantly look at social theory and ethnographic concepts through the lens of lived experience. My research always seems to return to that.

What drew you to this project?

I was thrust into working in the hospital in early COVID, at a time when I thought there was a good chance that I would die if I became infected (due to comorbid illnesses). I simply had to study that experience.

What was one of the most interesting findings?

The most interesting finding was that clinicians, afraid and trying to sort through rapid-fire contradictory ideas about COVID, entered a kind of trance, a bad trip, needing to imagine (or “hallucinate”) virus distributed everywhere. It was interesting that the fear wasn’t simply formless emotion, but that it infiltrated the very scientific expertise that they had previously thought of as objective.

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

I just finished Children of Time by Adrian Tchaikovsky. I thought it was just for pleasure, but there were so many wonderful ideas in it that it got my academic idea mill churning!

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

I think that we fantasize that doctors should be completely objective, and it blinds us to some of the very important effects that their own emotion and experience injects into health systems.

Interview With Nora S. West

Posted by michellezernick

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

Assistant Professor, University of California, San Francisco

I am a social scientist who uses qualitative and mixed methods within infectious disease screening, diagnostics, and therapeutics. My research interests focus on understanding mental health trajectories during diagnosis and treatment, the influence of mental health on engagement with infectious disease care cascades, and implementation science approaches for integrating mental health services into infectious disease care.

What is your article “Okweraliikirira and Okwenyamira: Idioms of Psychological Distress Among People Living with HIV in Rakai, Uganda” about?

This study explored how people living with HIV in rural Uganda understand and express psychological distress. Interviews were conducted with 42 people, including those living with HIV, healthcare workers, and community members. Two main local terms were used to describe mental distress: okweraliikirira (worry/apprehension) and okwenyamira (deep thoughts/many thoughts). These expressions of distress were specifically linked to HIV-related challenges like fear of death, stigma from family and community, disclosure concerns, and financial stress from managing HIV care. Both types of distress were said to worsen HIV medication adherence and could progress to more severe mental health problems if left unaddressed. Participants identified counseling and social support as key treatments. The study suggests that understanding culturally specific ways of expressing distress is important for healthcare provision. Using local terms rather than Western psychiatric labels like “depression” may help identify people who need psychosocial support and make screening culturally appropriate and effective.

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

My research focuses on understanding the dynamics of mental health across care and treatment cascades for infectious diseases, primarily, TB and HIV.

What drew you to this project?

I worked on several studies that used mental health screeners among people living with infectious diseases, and from that work, I realized that the interpretation of the screeners and expressions of mental distress did not always map onto commonly used screeners.

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

I have been reading Barbarian Days: A Surfing Life by William Finnegan and recently watched Downfall: The Case Against Boeing.

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

Healthcare providers, mental health programs, and researchers should consider the relevance of incorporating culturally specific idioms of distress—like “okweraliikirira” (worry/apprehension) and “okwenyamira” (deep/many thoughts)—into their screening and treatment approaches rather than relying solely on Western diagnostic frameworks.

Other places to connect:

Website

Interview With Nathalia Costa

Posted by michellezernick

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

*Senior Research Fellow, University of Queensland*

Nathalia Costa is passionate about deepening the understanding of healthcare issues through qualitative methods and methodologies, with a focus on theoretically grounded, critical, reflexive and collaborative approaches. She advocates for pluralist inquiries to achieve the intersubjective understandings needed for impactful collective action.

What is your article “Non-clinical Psychosocial Mental Health Support Programmes for People with Diverse Language and Cultural Backgrounds: A Critical Rapid Review” about?

This critical rapid review examined non-clinical psychosocial support services for culturally and linguistically diverse (CALD) populations delivered by lay health workers. Drawing on a critical realist framework and Brossard and Chandler’s taxonomy on culture and mental health, the review analysed 38 studies (10 quantitative, 7 mixed-methods, and 21 qualitative), mostly conducted in North America and Europe. While many interventions focused on specific populations (e.g., refugees, Latinx immigrants) and targeted outcomes like depression and trauma, fewer studies used multimodal approaches or focused on broad populations. Despite short intervention durations, most reported positive psychosocial outcomes. Qualitative findings underscored barriers such as inadequate resources and limited cultural alignment. The review found most studies operated within split-relativist paradigms, aiming to help participants navigate Eurocentric systems. Culturally responsive and context-sensitive models, prioritisation of social determinants of health and community engagement are likely to be critical to ensure best practice in non-clinical psychosocial support.

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

I am a Brazilian scholar living and working in Australia, and committed to shaping, enhancing and transforming quantitative evidence through qualitative methods and methodologies to make research, practice and education more inclusive and nuanced. With postdoctoral studies in policy and at the interface of clinical science and sociology, I draw from these disciplines to explore healthcare challenges and generate insights that drive meaningful change.

What drew you to this project?

I was drawn to this project through my longstanding collaboration with A/Prof Rebecca Olson and Dr Jenny Setchell, with whom I share a commitment to social justice and critical approaches to health research. An opportunity to evaluate a service providing non-clinical psychosocial support for people from multicultural backgrounds came up, and we thought it was important to ground our evaluation in a rigorous and critical understanding of best practice in this area. Rebecca invited me to co-lead the rapid review with her, and I enthusiastically accepted, seeing it as a valuable opportunity to contribute to work that aligns with my values and interests in diversity and policy-informed research.

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

I have been reading The view from Nowhere, by the philosopher Thomas Nigel. It is a book about subjectivity and objectivity – he argues that pure objectivity is impossible because we are embodied, situated beings. As far as I can tell from what I read so far, the book calls for a balance between subjectivity and (inherently limited) objectivity.

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

It would be great if researchers and practitioners working in non-clinical psychosocial support for people from multicultural backgrounds to move beyond eurocentrism and individualistic understandings and approaches to mental ill-health, and instead adopt approaches that are grounded in an understanding of social, cultural, structural, historical and political contexts.

Other places to connect:

Website

Interview With Agnes Ringer

Posted by michellezernick

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

Editor, Hans Reitzels Forlag; Part-time Lecturer and Researcher, Roskilde University; Visiting Scholar, Vrije Universiteit Brussels

Agnes Ringer, is a clinical psychologist and interdisciplinary mental health researcher. She works as an editor in psychology and lectures part-time at Roskilde University. Her work centers on psychiatric practice, recovery, and the social dimensions of mental distress. Currently, she is a visiting scholar in Vrije Universiteit, Brussels.

What is your article “Troublesome Bodies: How Bodies Come to Matter and Intrude in Eating Disorder Recovery“ about?

This article explores how the body becomes a site of tension and meaning in the process of recovery from eating disorders. Drawing on interviews with participants in a group therapy program, my co-authors, Mari Holen and Anne Mia Steno, and I show that recovery is not just about changing eating behavior or mindset—but about navigating how the body is viewed, judged, and experienced. We use theoretical perspectives from Sarah Ahmed and Analu Verbin to examine how bodies are shaped through social space and cultural paradoxes. The article introduces the concept of the ‘troublesome body’ to highlight how participants simultaneously seek and resist visibility, control and surrender,
and how their agency emerges through collective spaces like group therapy.

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

I’m trained as a clinical psychologist and hold a PhD in interdisciplinary mental health.
My research focuses on psychiatric institutions, recovery, and how mental distress is
shaped by and expressed within social and institutional contexts. I’m especially interested
in how people respond to adversity—not as passive victims, but as meaning-making
agents who navigate their lives with dignity. My work draws on psychological,
sociological, and anthropological perspectives.

What drew you to this project?

The project grew out of my experience working in a clinic for eating disorders that used
group-based, narrative, and systemic therapy. I was struck by how transformative the
group process was, and how central the body became in participants’ stories. While my
co-authors and I set out to explore social aspects of recovery, we discovered that recovery
was deeply entangled with how participants experienced and navigated their bodies.

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

Right now, I’m re-reading Agnes’s Jacket: A Psychologist’s Search for the Meanings of
Madness by Gail A. Hornstein. It’s a powerful exploration of first-person narratives in
mental health and what they can teach us about experience beyond diagnosis. I’m also
watching Hacks—a smart, sharp comedy that explores vulnerability, creativity, and
power dynamics.

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

That recovery from eating disorders is not a linear, individual journey. It’s deeply social,
relational, and shaped by the environments we inhabit. We need spaces where people can
explore their paradoxes, be seen without judgment, and co-create new meanings together.

Other places to connect:

Website