This undergraduate course introduces ways anthropologists theorise and research mental disorder, treatment and recovery. It reflects a growing interest in anthropology’s encounter with the key ‘psych’ disciplines and the human and social sciences, evident in the well-spring of new university courses in psychological and psychiatric anthropology in the U.S, Canada and Australia, and the transnational migration of this interest to Europe, Asia, and the global South. Taking as given the shifting meanings of ‘abnormality’, the title reflects the priority given to the term disorder over disease. Disorder, as Good (2012) argues, can encompass historical, political, psychoanalytic, postcolonial studies and other comparative approaches—linking the madness of the state and individuals, and forcing attention to the often violent ways political moral and epistemic ‘orders’ are established (518).
The challenge lies in synthesising diffuse classic, and burgeoning contemporary, literatures in a concise engaging and accessible way for students. In designing this course for primarily psychology students, I found older readers in psychological anthropology engaging heavily with psychological theory and applications across diverse topics not necessarily related to mental health—hence the focus ‘too general’. In engaging mental health and illness, others tended to prioritise the lens of culture, or else single disorders—hence the focus, although rich, ‘too narrow’. So one way I’ve tried to bridge the lacuna is by compiling lists of key and additional readings—and of ethnographic films and websites like Somatosphere which are valuable tools for cutting through the complexity of the literature.
This course addresses ten diverse topics, linked via some key paradigmatic and theoretical frames. These broadly encompass anthropological representations of ‘culture’, and their relation to (the equally unwieldy terms) ‘biology’ and ‘structure’. One objective is to consider anthropological thinking about psychiatric illness in order to identify how anthropologists can assist thinking through classificatory problems of cultural and conceptual translation. A second concerns the goals of treatment, rehabilitation or therapy. What underpins expectations of a ‘return to normality’? Does medicine’s goal to ‘cure the symptom’ mean suppressing rather than exploring their problems? Third, can, how, or even should an anthropology of mental disorder bring its expertise and methods to improve the suffering of patients? These questions about positioning are presented as driven partly by funding priorities, governments, universities and research councils; but also by anthropology’s struggles to overcome its own identity problems rooted in esotericism, elitism and the legacy of colonialism.
One broad aim is to overview the epistemic shift from explanations dominated by cultural and structural ecologies to those from studies in biomedicine, biological and global psychiatry, neuroscience and global mental health. These shifts have been shaped by a confluence between local intervention and specificity—through ‘local biologies’ (Lock 1993)— alongside the mass reconceptualization of mental illness as neuro-psychiatric or brain disorders. In U.S. psychiatry the ‘brain disease’ model of mental health is dominant. Whilst anthropologists typically emphasize social, contextual and cultural influences on mental illness, challenges to assumptions about context and the environment are increasingly coming from biocultural anthropologists, and from critiques that draw on emerging techniques in clinical science and brain studies.
The re-turn to biology via brain studies and neuroscience is of course not the whole story. It has met with strong critiques from cultural psychiatry, psychoanalysts, activists (including psychiatrists) and political movements. This short course cannot solve the irresolvable question of theory’s relation to practice. Rather, it seeks commensurability in relation to some interpretations crafted by anthropologists of mental illness, abnormality and disorder. It does this by tracing these debates through time, across varied social and cultural settings, through their geographical distribution across the globe, and by subjecting single ‘disorders’ to political, cultural, social and biomedical scrutiny.
Mental disorder can provide an innovative, challenging way to think about the ongoing transformation of anthropological knowledge at a time of increasing fragmentation of inquiry, while also connecting it to traditional forms of anthropological scholarship and debate. This is a work in progress for both teachers and students. Please do share suggestions for readings, films, links to wider topics etc.
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Nichola Khan is a Senior Lecturer in the School of Applied Social Sciences at the University of Brighton, UK. Her research interests in social and psychological anthropology have developed around violence, transnational migration, mental disorder and theories of suffering—via a regional focus on Pakistan, Afghanistan and Afghan diasporas.
Good, B. 2012. Theorizing the ‘subject’ of medical and psychiatric anthropology. Journal of the Royal Anthropological Institute, 18:515–535.
Lock, M. 1993. Encounters with Aging: Mythologies of Menopause in Japan and North America. Berkeley, CA: University of California Press.