Histories and ethnographies of psychiatric encounters: Introducing DECOLMAD’s first post-doctoral fellow
In this blog post, we introduce Dr Lamia Moghnieh, who will be joining the DECOLMAD project in May 2021 as a post-doctoral fellow. Lamia is an anthropologist and a mental health practitioner (MSW, MA in Psychology) specializing in the fields of medical anthropology and global mental health. Below, she writes about her fascinating research so far, and what participation in DECOLMAD might mean to her as a scholar.
My research broadly looks at the interplay and impact of psychiatry on cultural understandings of self and illness in postcolonial and post-conflict societies of the Middle East and North Africa (MENA)/South West Asia and North Africa (SWANA). I am particularly interested in grounding the relationship between psychiatry and subject formation in the context of global standardization of health sciences, on the one hand, and in a situated analysis of local social and political transformations, on the other.
Psychiatry and its classifications have social lives that profoundly affect experiences and management of illness, minds and bodies. The cultural authority of psychiatry lies in its hermeneutic capacities; in its ability to generate schemes and concepts (in the form of ideas, discourses, arguments about our emotions, cognition, bodies, thought process, sexuality etc.) that seem to permeate into our lives, defining us, our relations with each other, and our positions in society.
I locate the sources of psychiatry’s cultural authority not only in its institutional power but in the discipline’s generative conceptual apparatuses. This authority is also manifested in the transformations of the reach of psychiatry itself, in the kinds of people, social phenomena, and sites that become the subjects of psychiatric governance at a specific moment in time. As a medical anthropologist, I examine clinical and psychiatric archives first out of a methodological necessity to contextualize, historicize, and deepen my ethnographic account of contemporary psychiatry and its transformative authority. My research brings together interdisciplinary methodologies from History and Anthropology to critically approach the clinical encounter as a site of knowledge-making and reform, where patients’ voices can also be excavated. I document the scientific and social tensions and dialogues emerging from these encounters in both the MENA/SWANA and Europe, dedicating particular attention to the psychiatrization of women and the refugee/migrant experience.
Current research
My current book manuscript titled Psychiatric Encounters at the Periphery: Illness, Gender, and Society in Lebanon is an account of the knowledge practices of modern psychiatry in Lebanon during periods of colonialism, national development, and war. Through different case studies of clinical encounters, the book examines the different projects of psychiatry in Lebanon from missionary medicine and insane asylums to institutional psychiatry, transcultural psychiatry, and finally humanitarian psychiatry. Each encounter and project has assembled different actors and discourses in Lebanon, such as patients, family members, political parties, illness/pathology, war, psychiatric therapeutics and classifications, scientific collaborations, medical migration, mental health professionals, global humanitarian health agencies, hospital administration, etc. One of the book’s objectives is to demonstrate how psychiatric thought, science, and authority reconfigured specific subjects and events in the context of a changing socio-economic, gendered, and political order in Lebanon, and how psychiatry classifications were interpreted and valued by various communities.
Participation in DECOLMAD
DECOLMAD offers a unique and exciting chance to historicize the emergence and development of transcultural psychiatry after World War II as a postcolonial project of psychiatry that held a new promise for a universal classification and treatment of mental illness. Most importantly, the project sought to disentangle culture from the realms of colonial and imperial quests, as being a marker and a cause of mental illness in colonial subjects, and relocate it as a set of local dynamic processes, schemes and relationalities that can help professionals to understand and redefine mental illness and the discipline of psychiatry itself. Transcultural psychiatry also produced new ways of understanding illness within and across cultures, all the while maintaining a universalist approach to psychiatry.
In this sense, transcultural psychiatry is a project of decolonization. What the archives provided by DECOLMAD offer to a medical anthropologist and practitioner such as myself is an opportunity for a double account of decolonization. First, as processes of scientific re-assembling, in which mental health professionals of the Global South and the metropole exchanged and negotiated new conceptualizations and classifications of mental health while taking into consideration the local context and the cultures in which illness emerges. Understanding this process as a form of decolonization also implies paying attention to the multiple epistemological forms of knowledge produced on psychiatry and mental illness, rather than reading transcultural psychiatry in different sites simply as a localized manifestation of a global mental health project. This scientific labour of dis-entangling culture from mental illness and rendering it a source of knowing the patient and her affliction reverberated not only into doctor-patient relationships but into the patients’ relations to their families and society as a whole. Second, the archives provide an impetus for an alternative reading of predominant clinical narratives that anchors the voices of patients back into the history of psychiatry, as knowledge producers and crucial actors in the making of transcultural psychiatry. It is precisely in these kinds of readings of psychiatric archives that I am interested, ones that render marginal and subaltern voices of patients equally legible and crucial to the pursuit of knowledge and treatment of mental illness.