Reading the vast panorama of the history of Western medicine in general and psychiatry in particular sheds an interesting light not only on social constructions and representations but also on the perception of the Other by the medical institution. Colonial medicine in its struggle - praiseworthy, moreover - against epidemics, presents an interesting case here. We read in the Colonial Medical Archives at Berlin, that a certain Dr Roesener was sent to Kamerun (Cameroon), a German protectorate, to take charge of (...) the eradication of malaria, hookworm (anchylostoma), filariosa and sleeping sickness. But he also found himself faced with mental illnesses and, in his report of October 1909, reported the case of a sick man of the Dwala tribe claiming to be a friend of the Kaiser and presenting all the symptoms of mental illness. A problem of nosography arose - stemming from the cultural perception of an illness and above all of the Other: did this Dwala merit being mad? To understand the meaning of this question, we must return to the German anthropology of the last century, which made a clear distinction between ‘natural people’ (Naturmenschen) and those that were civilized, who were part of Kultur. Moreover, in this report Roesener used the word Naturmenschen to signify the Dwala. In this perspective, as the doctor notes, mental illness was, in the medical teaching of that time, a disturbance of the mind, a malaise of civilization. The prerequisite for being mentally ill was being implicitly part of a civilization. Mental illness was, moreover, translated in German by Geisteskrankheit, in other words, literally, illness of the mind. Now, the ‘natural person’ (the Dwala) has no civilization and in consequence cannot be sick in his mind. And yet he presented all the symptoms which made him a classic mental patient. Could one apply the nosography proper to illnesses stemming from civilization to ‘natural peoples’? Without resolving the problem which his terminological usage posed, Roesener insistently demanded that Berlin send the logistical means to Cameroon to build a lunatic asylum (Irrenhaus). To the problem of mental fragility that was posed came the answer of incarceration in a society that knew nothing of confinement of its ‘mental patients’, the latter often not being considered as inferior. (shrink)

Starting from the experience of the Other, phenomenology takes otherness as something which withdraws from my own experience and exceeds the limits of our common orders. Radical otherness is something extraordinary, arising in my own body, situated between us and striking us before we look for it. Psychiatry confronts us with a peculiar sort of pathological otherness which in ethnopsychiatry is doubled to an otherness of a higher degree. We encounter the anomalies of other orders as if we were (...) dipping into the Other’s shadow. This brings up many questions. How is the pathic related to the pathological, the normal to the abnormal? How can psychiatry take account of the intercultural Other without sacrificing its otherness to universal points of view? How is the unconsciousness of our own culture connected with that of other cultures? To what extent does intercultural otherness affect our intracultural otherness? Is there an alternative to the extremes of fundamentalism and globalism, which tend either to repress otherness or to level it? (shrink)

Approaching mental health on a global scale with particular reference to low- and mid-income countries raises issues concerning the disregard of the local context and values and the imposition of values characteristic of the Global North. Seeking a philosophical viewpoint to surmount these problems, the present paper argues for a value-laden framework for psychiatry with the specific incorporation of value pluralism, particularly in relation to the Global South context, while also emphasizing personal values such as the choice of treatment. In (...) sketching out this framework, the paper aims to overcome the clash between universalism and relativism about psychiatric categories by focusing on how overlaps between cultures can contribute to ontology-building. A case study analyzing ethnopsychiatric research in the context of South India will illustrate the proposed view, while also pointing out avenues for further research on the causal efficacy of local shared beliefs about mental disorder. If approaches across different traditions and theoretical frames are shown to work in treating similar ailments, causal connections appear to cut across the different ontologies. Ethnopsychiatry would play a central role in such research, namely in disclosing the variables and mechanisms at work within the local approaches. (shrink)

Frantz Fanon is principally known as a great theoretician of race relations and decolonization, in particular through the two main books he published during his lifetime Black Skin, White Masks and The Wretched of the Earth. What is less known is that he was in parallel a pioneering psychiatrist and an early and recognized theoretician of ethnopsychiatry. A volume of about a thousand pages of texts either difficult to access or presumed lost was recently published, following more than a (...) decade of research in archives located in different parts of the world. It reveals first the importance and originality of his thought as a scientist, and secondly the importance of this dimension of his work for the understanding of his political texts. This is shown on two points: 1) the role of violence in the decolonization process, when compared with Fanon’s texts on psychiatric internment, the phenomenon of agitation and the alternative model of social therapy and 2) the use of «identity» as cultural foundation for newly decolonized states, which he strongly criticised, when compared with Fanon’s systematic questioning of any personal «constitution» in his psychiatric and ethnopsychiatric work. (shrink)

This essay provides readers with a critical analysis of the ethnographic sciences and the psychological warfare used by the British and Kenyan colonial regimes during the suppression of the Mau Mau rebellion. In recent years, several survivors of several detention camps set up for Mau Mau suspects during the 1950s have brought cases in British courts, seeking apologies and funds to help those who argue about systematic abuse during the times of “emergency.” The author illustrates that the difficulties confronting Ndiku (...) Mutua and other claimants stem from the historical and contemporary resonance of characterizations of the Mau Mau as devilish figures with deranged minds. The author also argues that while many journalists today have commented on the recovery of “lost” colonial archives and the denials of former colonial administrators, what gets forgotten are the polysemic ways that Carothers, Leakey, and other social agents co-produced all of these pejorative characterizations. Kenyan settlers, administrators, novelists, filmmakers and journalists have helped circulate the commentaries on the “Mau Mau” mind that continue to influence contemporary debates about past injustices. (shrink)

ABSTRACT This article argues that Frantz Fanon’s critique of the epistemology of the colonial situation is a complex, pluralized, epistemology of ignorance, where ignorance takes three main forms. Fanon first produces a critique of colonial ideology, in which ignorance is the product of the colonizers’ false justificatory ideology. Fanon unveils how Europeans, through human sciences such as “ethnopsychiatry” and “ethnophilosophy,” deliberately produce ignorance and devaluation of colonized subjects and colonized knowledge for purposes of domination. Second, ignorance is the unintentional (...) result of the partial, situated, standpoint of embodied knowers. Fanon does not intend to substitute a “black truth” to white ideology. He rather insists that while truth is unattainable under colonial conditions, the affective perspective of the oppressed/colonized is a necessary constitutive part of any objective account of the world. Third, by analyzing the “Conducts of confession in North Africa,” characterized by deliberate denial, lies, and opacity as resistance mechanisms, Fanon insists that no objective knowledge is possible in a colonial situation because of the total separation, and impossible epistemic collaboration, of dominant and dominated knowers. An anticolonial politics has to focus on producing the conditions of possibility of knowledge. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.1 (2003) 25-27 [Access article in PDF] Gender, Body, Meaning:Anthropological Perspectives on Self-Injury and Borderline Personality Disorder Carolyn Sargent THE CENTRAL THEMES OF "Commodity Body/Sign: Borderline Personality Disorder and the Signification of Self-Injurious Behavior" reflect issues that cut across the disciplines represented by this journal and have received increasing attention from anthropologists. Medical anthropologists, as well as psychological anthropologists and others interested in symbolic analysis (...) of the body, have addressed such topics as the culture of biomedicine and the cultural shaping of psychiatric classification, the multiple meanings of body modifications, power relations in therapeutic interactions between doctor and patient, and cultural variation in understandings of normality and abnormality.Curiously, there is little anthropological literature that directly focuses on either borderline personality disorder (BPD) or self-injurious acts per se. Indeed anthropological research on psychiatric diagnosis, classification, and treatment, as well as ethnopsychiatry, include scant reference to personality disorders. One exception is Nuckolls' 1992 article, "Toward a Cultural History of the Personality Disorders," which raises pertinent questions for one of Potter's introductory statements—that the majority of those diagnosed with BPD are women. Nuckolls directly addresses gender ideology and gender roles in the United States in his comparison of antisocial personality and histrionic personality diagnoses. In his paper, he argues that these personality disorders have cultural histories and are strongly congruent with prevailing gender stereotypes, such that men are many times more likely to be diagnosed as antisocial than women and women much more likely to be diagnosed as histrionic (Nuckolls 1992, 37). He also historicizes the emergence of certain behavioral styles that have been seen as characteristic of women and men, and the evolution of psychiatric diagnoses that classify extreme manifestations of these behavioral styles.The issue of why women, rather than men, are more frequently diagnosed with BPD is not elaborated in Potter's article, although she notes the importance of considering the intersection of gender and "identifying behaviors" associated with BPD. Cultural analyses of gender ideology in the [End Page 25] United States might suggest that the connection involves gendered expectations concerning emotionality and relational context but these articulations remain intriguing and underexplored. One might speculate that BPD/self-injury occurs in the context of particular gender ideologies, perhaps in class-based, industrialized societies where the body is highly commodified. It appears that the history of this constellation of symptoms and behaviors remains to be written.Cultural analysis of self-injury, a theme that runs through Potter's article, tends to be embedded in the anthropological literature on body ornamentation, initiation rituals, and "culture-bound" syndromes. Mascia-Lees and Sharpe (1992, 1) describe the body as "a site of adornment, manipulation, and mutilation," practices with roots reaching back as far as 30,000 years, and include as examples head deformation, scarification, foot binding, tooth filing, lip plates, nose rings, tattoos, subincision, and genital cutting.However, the concept of self-injury, as Potter notes, is problematic in the discipline of anthropology given the significance historically accorded to cultural relativism. Correspondingly, body "modification" is not "self-injury" as long as it is socially normative, for example, a facet of an initiation ordeal or body ornamentation (e.g., circumcision, scarification, piercing). Among the rare examples of acts that seem readily identifiable as "self-injury" are New Guinea practices of cutting off a finger to demonstrate mourning and Baatombu (West African) male finger amputation to show grief and anger over a wife's infidelity. Both are, however, considered culturally legitimate and not indicative of pathology.Potter's argument draws heavily on the notion of "body as text," derived largely from literary theory and feminist philosophy (Butler 1990; Jaggar and Bordo 1989). The perspective of "body as text" has influenced anthropological theory over the past two decades, particularly in the interpretive and postmodernist schools of thought. The body as a text of femininity is aptly characterized by Bordo, who argues that the continuum between female disorder and normal femininity is revealed by means of an analysis of symbolic meaning of gender in... (shrink)

Pour la médecine occidentale moderne, l'affaire est entendue : c'est le médicament qui soigne, à savoir une substance chimique aux effets biologiques bien identifiés. Pourtant, une médecine peut en cacher une autre : tous les patients savent intuitivement que l'attitude du thérapeute à leur égard peut être aussi décisive dans la guérison que les médicaments qu'il délivre. Et sans même qu'il soit nécessaire d'évoquer les " médecines parallèles ", le mystère scientifique que représente l'effet placebo témoigne de la persistance des (...) phénomènes de suggestion au cœur de la médecine moderne. Dans ce livre, Philippe Pignarre propose une compréhension nouvelle de cette dualité que la science résiste à reconnaître. Il le fait en se penchant sur l'histoire, et plus précisément sur l'histoire de la psychiatrie, en suivant les deux " fils rouges " : d'une part, celui qui court du "baquet" autour duquel, à la fin du XVIIIe siècle, Mesmer rassemblait ses patients pour les " magnétiser ", jusqu'à la psychanalyse, en passant par les cures hypnotiques de Charcot ; et, d'autre part, celui qui relie l'invention par Pinel du " traitement moral " des aliénés à la psychiatrie biologique d'aujourd'hui. Il montre ainsi comment la médecine de la suggestion et la médecine somatique n'ont jamais réussi à faire bloc. Et que cette séparation pourrait bien être à l'origine des plus graves difficultés auxquelles se heurte la médecine moderne, qu'il s'agisse de l'usage des drogues illégales et de son " traitement ", ou de la surconsommation de psychotropes, dont la France détient le record mondial. L'auteur ouvre ainsi des pistes passionnantes pour retrouver dans notre héritage occidental - mais aussi, grâce à l'éthnopsychiatrie, dans celui d'autres civilisations - les éléments qui permettront de ne plus construire les deux médecines l'une contre l'autre. (shrink)