Global Histories of Psychiatry

Global Histories of Psychiatry

Hubertus Büschel / Alexis Tancrède Pagès, University of Groningen
Vom - Bis
07.11.2018 - 08.11.2018
Url der Konferenzwebsite
Alexis Pages, Department of History, University of Groningen

This workshop challenged existing scholarship of psychiatric history with the intention of discerning and promoting new methodological approaches that would yield broad research objectives of explicating the particularities of psychiatric vernacular in (g)local settings, shedding light on transnational transference of knowledge production and perceived expertise and questioning the role psychiatry has served within historical contexts.

The workshop’s tone was set by NANCY R. HUNT’s (Gainesville) keynote lecture, in which she spoke of the need to sidestep the traditional means by which psychiatry is understood to confront hierarchies in psychiatric discourse. She insisted that, as historians, it was integral to successfully trace parallel, unofficial practices of psychiatry by breaking away from the dominance of archives in discourse by contextualizing the moods, metaphors, and milieus of madness within socio-cultural settings. In pursuit of this, it would be possible to relocate knowledge to a new historical context, or ‘vernacularization’, yielding a more nuanced understanding of psychiatric practice in non-European spaces and places.

SLOAN MAHONE (Oxford) presented her paper in which she explored the implications of Canadian psychiatrist Edward Margetts’ photographic documentation of ceremonies and dances in Kenya’s Taita District during the mid-1950s. Local officials in Taita were worried by what they perceived as high-levels of ‘hysteria’, demonstrated by the high presence of disturbed behavior and outbursts of violence. Through Margetts’ expansive photo-series, Mahone argued how local traditions and rituals were ascribed meaning from a Western psychiatric practitioner’s gaze, representing a convergence of two irreconcilable vernaculars: the harsh contrast between men and women in Taita social relations accelerated by the introduction of Western technologies and customs.

MATTHEW M. HEATON’s (Blacksburg) presentation addressed Dr. Raymond Prince’s 1958-59 study of four secondary schools in southern Nigeria idenifying a psychiatric pathology he coined, ‘brain fag syndrome’. Seeking substantive evidence of its existence, Prince argued that its prevalence in Nigerian children was caused by a cultural conflict between the communal nature of the ‘Nigerian personality’ and the individualistic nature of Western education. However, as Heaton demonstrated, Prince’s flawed methodology and prior prejudice enhanced notions that the ‘African mind’ was different to that of Westerners, thereby necessitating the identification and classification of this culture-bound syndrome, subsequently dismissed as a product of poor scientific work.

NINA STUDER (Bern) spoke of French colonial perceptions of alcoholism within the Muslim population of Algeria in her presentation. Projections of alcoholism amongst Algerian Muslims were in constant flux with reasonings shifting in accordance to what was most politically, and culturally, expedient for colonial administrators. On the one hand, consumption of alcohol was presented as an indicator of ‘civilizational supremacy’ due to the ahistorical trope that the Algerian population did not consume alcohol prior to French colonization. On the other hand, alcoholism within Algerian Muslim populations was understood by colonial psychiatrists as a manifestation of a cultural shock – assimilation into ‘modern’ society exerted too much on the ‘fragile’, or ‘primitive’ psyche of Algerian Muslims. Studer identified a colonial vernacular that identified the causes of alcoholism as being rooted in imagined histories of the colonized, oftentimes associated with religious practice, leading to differences in the diagnosis and treatment of alcoholism between the colonized and the colonizers.

Based on the ego-documents of a Cameroonian man diagnosed with schizophrenia, HUBERTUS BÜSCHEL (Groningen) explored the ways in which (post-)colonial psychiatry can be represented as a ‘double-silencing’: (post-)colonial regimes repressing dissent and psychiatric protocol inhibiting a patient’s speech from being taken seriously. The texts analyzed by Büschel are significant in that they represent the first published text of a ‘native’ diagnosed with schizophrenia where a high degree of lucidity and self-reflection is present. He argued that Mr. Tanka’s writings could be interpreted as a splinter of contemporary psychiatric discourse; Mr. Tanka constructs himself as the archetypical schizophrenic African who negotiates and contests, but ultimately mirrors, global discourses. This research lends itself to a possible history ‘from below’ where the African patient is an active agent (as opposed to a passive subject) of colonial psychiatric treatment and practice.

The first day was concluded by a screening of ROBERT LEMELSON’s (Los Angeles) documentary Shadows and Illuminations, one episode of a six part ethnographic film series titled Afflictions: Culture and Mental Illness in Indonesia. Concerning Kereta, a Balinese man who says spirits have intruded his consciousness, the film explores the meaning behind his mental illness. His experiences exceed cultural norms of comparatively frequent interaction with the supernatural world. Their precipitating factors and socio-cultural contexts complicate diagnostic frames offered by globalized psychiatry, such as PTSD or schizophrenia. The film provides insight into the potential origins of Kereta’s affliction such as experiencing trauma due to political violence, a haunting by grief over past losses, or indeed torment by invisible beings. His story emphasized the complexity of multiple, competing models of ‘madness’ that intersect, and at times supersede, biomedical models of psychiatric illness.

The second day was initiated by WALTRAUD ERNST’s (Oxford) keynote lecture in which she addressed the words and meanings of phrases deployed in historical psychiatric discourse. She criticized historiographic tendencies to ‘side-step the traditional’, which attempt to deconstruct the problematic tradition-modernity binary, by replacing one side of the conceptual binary with similarly fraught, vague and over-determined ones such as ‘parallel’, ‘unofficial’, ‘colloquial’, ‘subaltern’ and, finally, ‘vernacular’. While a change of terms may lead to fascinating new insights into how resistance and authentic mindsets manifested themselves within structures of exploitation and ideological domination, there is a danger of losing track of the potential other side of the traditional/vernacular juxtaposition, namely ‘modernity’. The global dissemination of the WHO and western psychiatric associations’ ideas on templates for psychiatric diagnosis and practice considered suitable for the imagined ‘Global South’ after some adjustment for ‘cultural’ idiosyncrasies, require as much critical assessment as the attempted transfer of western paradigms of psychiatry during the colonial period. Critical history of madness and psychiatry during the colonial era focuses on resistance and subversion as well as on the role of the colonial state; it is time for contemporary historians to consider the hegemonic role of agencies such as the WHO and the American Psychiatric Association, the influence of their policy advisors in the shape of ‘cultural experts’ such as medical anthropologists and, last but not least, the global influence of the pharmaceutical industry.

In his paper presentation, RICHARD KELLER (Madison) sought to trace the constancy of universalism in psychiatric discourse even as it has shifted its ontological ground over the past two hundred years. With notions of civilization, race, mind, brain, and place serving as critical modifiers of the universal, Keller drew attention to the ways in which the universality of mental illness has adapted to an ever-changing global discourse of psychiatry as an anchor that unifies humanity in its increasingly understood disparity and multitude of particularities.

ALEXIS TANCRÈDE PAGÈS (Groningen) presented his paper based on a death certificate ledger found in the archives of the aforementioned psychiatric institute. Pagès argued that through these death certificates, it is possible to discern a cultural construction of how a ‘good’, ‘natural’ death was understood. Death certificates served an organizational logic by applying a logic of causation that nominally legitimizes and exonerates medical practices taken prior to death. Indeed, the presentation was less about how and why patients died, but rather the ways in which staff members interpreted these deaths according to a logic of mental illness.

In his presentation, RICHARD HÖLZL (Kassel) analyzed how psychiatric ailment and failure of faith were intertwined in colonial Africa. Particular attention was given to Christian communities and how they were secured through evangelizing, ensuring that the ‘relapsing’ of convert was minimized, preserving the divine word despite linguistic and cultural translation, negotiating Christian rituals and procedures with existing ‘native’ ones, and exalting the sincerity of missionary work. To emphasized his argument, Hölzl examined the case of William James, a Tanzanian convert and member of a monastery subjugated to external observation, monthly obligations to self-incrimination, and restricted mobility due to his perceived lapses of falling out of faith. This paper served to underscore the extent to which missionary work emphasized the individual’s psychiatric self, particularly the clash between the ‘savage’ or ‘primitive’ mind with ‘civilized’ or ‘enlightened’ Christian ideals.

Presenting pieces of art from the unique Prinzhorn Collection, THOMAS RÖSKE (Heidelberg) showcased the potentiality art produced by psychiatric patients can have in subverting historical narratives of madness. The collection is comprised of approximately 6.000 unique pieces, all created by psychiatric patients/inmates between 1840 and 1940. As Röske emphasized, the collection provides unique insight into a handful of patients, making the field of psychiatry visible and, more precisely, the individuals who find themselves trapped within an institutional framework that eliminates capacities of individual expression. The pieces are ‘eruptions of the subconscious’ oftentimes addressing social taboos such as sexuality and gender norms. Furthermore, the collection is a testament to early attempts to integrate art therapy into everyday treatment.

In his presentation, JONATHAN SADOWSKY (Cleveland) endeavored to trace a genealogy of depression, encompassing its innumerable definitions imbued with conflicting notions and conceptualizations. In its totality, depression is a bloated category; a psychiatric pathology that can include over thirty unique markers. Sadowsky sought to ask fundamental questions about the diagnosis of depression. His presentation did less answer the question ‘What is depression?’ but rather posed new queries of how one has to study the history of the pathology, what methodology should be implemented, to what degree can a definition be universalized, and if so, would it be advantageous to discard socio-cultural particularities in local settings?

Drawing from innovative source materials, the presentations of Heaton and Büschel showcased the new approaches to research ‘histories of entanglement’ between Western/Non-Western psychiatric discourses with ambitions of deconstructing, or reformulating, the ways in which colonial psychiatric practices can be understood. Lemelson’s documentary, alongside Hunt’s keynote lecture and Keller’s presentation, underlined the importance of emphasizing the role global negotiations of experience have in tracing epistemic origins of psychiatric discourse by critically reading clashes between ‘local’ knowledge and Western knowledge. In turn, we are able to identify a vernacular of ‘madness’ that incorporates a spectrum of ideas and notions entangled with one another. The presentations of Hölzl, Mahone and Studer equally showcased the pervasiveness of narratives that incorporate ‘experiences’ of ‘traumatic modernization’ in which colonized populations were adversely affected mentally by an unprecedented subversion of their mode of reasoning characterized by violent subjugation and exploitation, enforced disruption of ‘traditional’ practices or knowledge of psychiatric ailments, and endeavors to ‘civilize’ the ‘primitive’. Pagès and Röske demonstrated the potential significance of exploring new archives as a means of deriving new histories that challenge how we understand and interpret the practice of psychiatry in both local and global settings. Both Ernst’s and Hunt’s keynote lectures argued for a novel historiographic approach that takes into consideration alternative milieus of knowledge production beyond the insular world of psychiatry. Finally, Sadowsky’s expansive presentation underscored how as a category of psychiatric ailment, depression is wholly dependent on the particular socio-cultural factors that affect the ways in which an individual is to be diagnosed with and treated for this affliction.

Conference Overview:

Hubertus Büschel (University of Groningen): Welcome and Introduction

Keynote Lecture
Nancy R. Hunt (University of Florida, Gainesville): Madness, Psychiatry, and the Vernacular

Sloane Mahone (University of Oxford): Casting Out Anger: Stress, Possession and Hysteria in Taita, Kenya

Matthew M. Heaton (Virginia Polytechnic Institute and State University, Blacksburg): The Doctor Describes it as ‘Mental Disorder’: Student Anxiety and Brain Fag Syndrome in Late Colonial Africa

Nina Stuber (University of Bern): Sharing a Drink: A History of Alcoholism in Colonial Algeria

Hubertus Büschel (University of Groningen): Mr. Tanka’s Illness: Biopolitics of Schizophrenia in Colonial Africa

Film Screening and Discussion
Robert Lemelson (University of California, Los Angeles): Shadows and Illuminations

Hubertus Büschel (University of Groningen): Closing Remarks for Day 1

Hubertus Büschel (University of Groningen): Welcome and Introduction Day II

Keynote Lecture
Waltraud Ernst (Oxford Brookes University): Global Histories of Madness

Richard Keller (University of Wisconsin, Madison): World Mental Health Twenty Years Later: The Impact and Limitations of a UN Report

A. Tancrède Pagès (University of Groningen): Sanctioned Dying: A Cultural History of Death in Lutindi Mental Hospital, Tanzania

Richard Hölzl (Georg-August-Universität Göttingen): The Psyche and the Soul: Missionary Anxiety and the Psychology of Conversion, 1900s to 1950s

Jonathan Sadowsky (Case Western Reserve University, Cleveland, OH): Depression and Culture: The History of a Global Mental Health Conundrum

Thomas Röske (Prinzhorn Collection of the Psychiatric University Clinic, Heidelberg): Modernism and Madness Regarding Sex, Gender, and Sexual Inclination in Drawings of the Prinzhorn Collection, Heidelberg

Hubertus Büschel (University of Groningen): Closing Remarks