by Thomas Furse

Ana Antić is a professor in the Department of English, Germanic and Romance Studies at the University of Copenhagen. Her research focuses on the history of modern Europe and its global connections, history of war and violence, and history of the ‘psy’ sciences. Antić’s first monograph is Therapeutic Fascism: Experiencing the Violence of the Nazi New Order (Oxford University Press, 2017); she is currently completing the second one, titled Non-aligned Psychiatry in the Cold War.

She spoke with Thomas Furse about her recent JHI review essay “Psychiatry and Decolonization: Histories of Transcultural Psychiatry in the Twentieth Century” (volume 85, issue 1).

Tom Furse: The books you discuss in this review each examine the complex information flow and knowledge circulation between the “center” and the “periphery” to a greater or lesser extent, in some places, such as colonial Vietnam, local knowledge and practices fused with Western psychiatry (as seen in Claire Edington’s book Beyond the Asylum). As Sarah Pinto’s book The Doctor and Mrs. A shows, the Indian psychoanalyst Satya Nand proposed an ‘objective method’ that integrated local practices to counter Western-centric universalism. Yet, as we find in Yolana Pringle’s book, Psychiatry and Decolonisation in Uganda, Benjamin Kagwa, in the newly independent Uganda in the 1960s, did not step out of the colonial framework in his diagnosis of mass hysteria among populations who lacked the intellectual, institutional and psychological capacities for modernity. As a response to this, many African psychiatrists tried to “Africanize” the practice in the hope of shedding its European colonial legacy. This created an essentialist view of Africans that recreated stark differences between the African and European ‘mind’ or ‘culture.’ Much of this boils down to categorizing world universalism and local essentialism. Do you think there is a way out of this binary for a truly transcultural psychiatry? Can Western psychiatry be provincialized?

Ana Antić: I think that provincialization of Western psychiatry is a fruitful idea, and one that has so far been perceived as quite radical (as one of the leading UK psychiatrist, Julian Leff, said Western medicine should not be seen as any other import from the West—such as, for instance, Coca-Cola—because it contained universal and superior knowledge about human illness and treatment, and was more than a set of culturally bound products and beliefs). This kind of medical and psychiatric universalism has remained problematic in its Eurocentric approach, and many critics have seen it as a form of neo-colonialism. On the other hand, in the mid-20th century, universalist psychiatry was just one segment of a much broader and politically progressive, universalism, which challenged the racial hierarchies of the colonial order and supported universal human rights. Many psychiatrists from the decolonizing territories could then subscribe to this new universalist psychiatry, because it promised to finally acknowledge the universal value and humanity of all patients.

At the same time, however, this made it possible to establish European and Westen psychiatry as the norm against which all other systems of belief should be measured—‘universal psychiatry’ never departed significantly from European ideas tested in European patients. But from the very beginning of transcultural psychiatry, there were practitioners who approached these debates very carefully and who initiated thoughtful collaborations between Western and non-Western institutions and ideas of suffering and healing. I think the way forward is in thinking about the clinical relevance of ‘culture’ in a very nuanced way—like many who work at the intersection of anthropology and cultural and social psychiatry have already done. I mean that culture should not be seen in reductive terms, as divorced from socio-economic phenomena and political contexts and beliefs, and it should not be understood as a superficial veneer but something that fundamentally shapes the nature and experience of psychiatric (and any other) illness.

TF: Your review points out that historians have sometimes overlooked Frantz Fanon’s clinical work compared to his political activism and writings. One of the books in your review, Camille Robcis’s Disalienation, explores how culture fits into his thinking about psychiatry and clinical work in the context of one psychiatric hospital in Vichy France. Fanon’s anti-colonialism and his depth of knowledge and practice of psychiatry placed him at the center of transcultural psychiatry. Yet, he seems more of a critic of it in your review. How does his ‘culture of agony’ fit with transcultural psychiatry? Was this a potential path of liberation away from the authoritarian tendencies in Western psychiatry? 

AA: Yes, one would expect Fanon to be at the very center of post-colonial transcultural psychiatry—he explicitly reckoned with psychiatry’s colonial legacies but also had a lot of educational and professional experience in the context of European psychiatry and relied on various Western clinical practices throughout his career. In Algeria and Tunisia, Fanon worked explicitly to ‘translate’ European psychiatric interventions and ‘adapt’ them to different socio-cultural (and political) settings. At the same time, Fanon stood out because he was much more interested in the politics of both psychiatric illness and psychiatric cure than in ‘culture’. His concept of culture (and national culture) could not have been more distant from early transcultural psychiatry’s reductive and essentialist approaches. Moreover, even though post-WWII transcultural psychiatry often attempted to distance itself from its colonial predecessors, there were very few practitioners at that time who openly spoke about colonialism and the need to decolonize, and this certainly made Fanon a very odd and uncomfortable presence. In recent years, scholars have tried to weave Fanon back into discussions about psychiatry and decolonization, and the ones I have reviewed have done that in very creative and innovative ways. For me, the main point is that Fanon’s political writings are impossible to understand without his psychiatry, and vice versa. Katie Kilory-Marac’s invitation to consider what (often depoliticized) cultural psychiatry would have looked like had Fanon had a more important formal role in it is particularly productive, and I think it helps us see the history of post-colonial psychiatry in a much sharper light.

TF: The general relationship between organized religion and psychiatry has often/sometimes synthesized on pastoral and palliative care. Your review examines El Shakry’s The Arabic Freud and Stefania Pandolfo’s Knot of the Soul. In Pandolfo’s account, the relationship between Islamic and Western psychiatry is one of compatibility with their notions of the self, psyche, and soul. Western science and Islam fit in a wider “family relationship” and not in distinct competition. This fundamentally questions the constructed split between a secular (and Judeo-Christian influenced) West and the Islamic world. Might this help develop a more integrated history of the Mediterranean region and the connections between Europe and the Middle East?     

AA: One of the core paradoxes of early transcultural psychiatry was that, despite its universalism, it struggled to overcome its predominant focus on culture—culture was understood in a rather narrow and thoroughly depoliticized way as a set of ethnic, religious, and often exoticized characteristics and beliefs. This emphasis on the importance of cultural difference within the broader universalist and universalizing framework meant that any differences in clinical behavior were interpreted solely through the cultural framework. Transcultural psychiatry fretted about cultural clashes and incompatibilities and—again, despite its universalism—saw cross-cultural movements and changes as a possible source of mental pathology, which this new discipline would work to ameliorate. It is within this framework that the assumption emerged about the supposed intellectual incompatibility between Islam and psychoanalysis (or Western psychiatry in general). Pandolfo and El Shakry deconstruct this assumption in very effective ways, and their contributions are exceptionally important beyond the history and anthropology of psy disciplines.

TF: The advent of global intellectual history, the global history of political thought, and the diversity of political theory have pluralized the discipline beyond the Western canon. As this review demonstrates, psychiatry is becoming a significant research groove in the history of ideas and one where transcultural psychiatry seems to mesh well with the new diversity of our discipline. Where do you see future research in psychiatry?

AA: First of all, historical and anthropological research in the history of psychiatry is getting increasingly diversified in its geographical focus. We are already finding out much more about the complex relationship between psychiatry, culture, and historical or political contexts in the Middle East and North Africa, in Latin America, East Central Europe, and the Balkans, and this research is particularly valuable because it decenters the field and challenges the assumption that psychiatric modernity is by default Western. In fact, recent histories of post-Second World War transcultural psychiatry have shown how diverse global psychiatry was at that time: some of its most significant actors came from beyond the Western core, and a variety of original collaborations and interventions developed in different parts of the world which promoted alternative traditions and solutions. I think this is a most important point, not least because the current situation is so different—much more monolithic and dominated by knowledge produced in the West, while the exceptional plurality of the profession from the mid-20th century seems to have disappeared for good.

In relation to that, I hope that another important field of research is at the intersection of humanities/social sciences and psychiatry, perhaps within the field of medical humanities, which would be critical and autonomous but not isolated from the medical field. There are many examples of these disciplines developing in opposite directions or talking past each other, often in very hostile ways, but humanities and social science research is essential to nuance and complicate interpretations of culture in clinical contexts and to encourage reflexivity and historical awareness within psy professions. On the other hand, as a historian of psychiatry, I find it important to be in dialogue with clinicians and psychiatric researchers in order to be able to understand in greater depth the unique pressures, challenges, and concerns these professions are facing and why their starting points and core assumptions are sometimes quite different from our own in humanities.

Ana Antić is a social and cultural historian at the University of Copenhagen. Her research focuses on the history of modern Europe and its global connections, history of war and violence, and history of the ‘psy’ sciences.

Featured image: Pavillon de l’Administration de l’Hôpital Psychiatrique de Blida-Joinville in 1933. Wikimedia Commons.