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Politics of Mental Health and Psychiatry in the Emerging State

Panel 042, sponsored bySyrian Studies Association (SSA), 2018 Annual Meeting

On Friday, November 16 at 11:00 am

Panel Description
The history of mental health is a growing field that encourages a rethinking of the cultural, social, economic and political history of the modern Middle East. Changing health practices have produced a diverse medical and vernacular landscape that has been traumatic and contested as well as productive. Debates on mental health treatment have further contributed to larger conversations about the “modern” body and body politic. Emphasizing the relationship between mental health and the state, the papers in this panel draw on archival material, hospital records, interviews, historical fiction, and memoirs to explore the intersections of colonial psychiatry, mental illness, asylums, modernity, state policies, trauma, and conflict in Algeria, Syria, Lebanon, Palestine, and Egypt. This panel presents current research building on the works of Richard Keller, Omnia El Shakry, Meghan Vaughan, Christopher T. Dole, Cyrus Schayegh, Sara Scalenghe and others. The first paper examines Algerian colonial psychiatry and settler colonial dynamics. In showing how mental health treatment was an instrument of power in settler colonial Algeria, the paper highlights how colonial psychiatry and institutions attempted to discredit indigeneity in all its forms. The second study explores insanity defenses raised in the courts of British mandate Palestine to uncover how criminal-legal responsibility was debated, evidenced, and staged by psychiatrists, legal officials, defendants, and their families. Participants argued about the relationship between responsibility and intoxication, crowd mentality, and norms of behavior rooted in the intersection of race, class, and gender. The third paper interrogates the impact of nominal independence in Egypt in 1922 on mental asylums and the mentally ill. By juxtaposing British and Egyptian control over these institutions and analyzing the “Egyptianization” of the management of mental illness, it reveals as much about the differences between the colonial project and the Egyptian state as their similarities. The final study blends medical, social, and cultural history approaches with anthropological and literary methods to analyze trauma, anxiety, and conflict in Lebanon and Syria. Biomedical and vernacular frameworks existed in tandem, and often in tension with one another, as the tumultuous events of the past 120 years led people to adopt survival strategies to cope with the ruptures of the past. The four presentations collectively serve as a contribution to the burgeoning fields of disability studies, trauma studies, and the politics of health in the modern Middle East, with exciting interdisciplinary potential connecting them to a range of debates in cultural and postcolonial studies.
Disciplines
History
Participants
  • Dr. Sara Scalenghe -- Discussant, Chair
  • Dr. Beverly Tsacoyianis -- Presenter
  • Monica Alessandra Ronchi -- Presenter
  • Dr. Yasmin Shafei -- Organizer, Presenter
  • Dr. Chris Sandal-Wilson -- Presenter
Presentations
  • Monica Alessandra Ronchi
    The interconnection between health and hegemonic power has been at the centre of studies from a variety of fields, ranging from political science to healthcare and policy. My work will use a historical perspective to analyse how mental health in particular has been used as an instrument of power in settler colonial Algeria. More specifically, this paper will look at visual sources to highlight how colonial psychiatry, settler colonialism and indigeneity intersected to create political narratives used by French authorities. My overall aim is to show how in Algeria, colonial psychiatry and institutions devoted to the study of human psychology have been used to discredit indigeneity in all its forms: firstly, by looking back to the establishment of an Algerian branch of colonial psychiatry, I am hoping to shed light on how the idea of an “indigenous mind” was rooted not only in science, but also in colonial politics. I then analyse how this new knowledge was instrumental to the establishment of the so-called Fifth Bureau, and to the design of propaganda material at the height of the Algerian War of Independence. This paper, which is part of my larger doctoral project, builds upon the theoretical foundations laid by thinkers such as Michel Foucault and Franz Fanon to highlight the interconnections between power and mental health within settler colonial contexts, in particular the re-elaboration of concepts such as indigeneity and the “primitive mind” to influence public opinion, shape settler colonial and indigenous knowledge production and delegitimise claims to political independence. My presentation draws upon original primary sources gathered through archival work, and will show the need for an open discussion about the portrayal of indigeneity and its strategic connection to the idea of “primitive mind” in settler colonial narratives. On a larger scale, this discussion impacts how we frame knowledge production in settler colonial contexts, and therefore shapes numerous fields of research including settler colonial studies and medical anthropology. Reflections on how psyche, mental health and power intersect are always worthy endeavours, but such reflections take on crucial importance when looking at hegemonic powers and their manipulation of colonial narratives.
  • Dr. Chris Sandal-Wilson
    Since the publication of Charles Rosenberg's Trial of the Assassin Guiteau in 1968, the question of criminal insanity has been productively mined by historians of psychiatry. For historians of colonial psychiatry, this has been particularly important. One of the key dilemmas facing colonial psychiatrists was where to draw the line between the normal and abnormal behaviours of colonial subjects; insanity defences raised in the courtroom forced psychiatrists - as expert witnesses - to answer this question, with literally life or death consequences, because behaviour which could be deemed 'normal' was behaviour for which a defendant could be held legally responsible. This paper takes as its focus insanity defences raised in the criminal courts of British mandate Palestine, drawing on newspaper reports, official publications, and archival material to uncover how criminal-legal responsibility was debated, evidenced, and staged by psychiatrists, legal officials, defendants, and their families in this context. While the historiography has been alert to the importance of gender in shaping expectations of 'normal' behaviour and thus the outcome of trials, this paper adopts a wider focus. In their verdicts, psychiatrists and the courts did not - and could not - disentangle categories like race, class, and gender in determining the responsibility of defendants. These debates, moreover, looked beyond the identity of the defendant alone. From the late nineteenth century, the mental responsibility of individual members of a crowd had been hotly debated in European sociology and psychology, and in Palestine, outbreaks of violence involving crowds lent a particular urgency to reflections on the limits of responsibility of individual members of a crowd. If membership of a mob might be taken to constitute a state of temporary insanity, another debate - whether intoxication, by drugs or alcohol, might attenuate mental and therefore criminal-legal responsibility - also played out in the space of the colonial courtroom too. Though these criminal cases forced the staging of these debates, the complexity of these cases and different agendas of participants meant that far from clarifying the lines between normal and abnormal, sane and insane, responsible and irresponsible, the answers produced in each case remained contingent and specific; it was only when colonial officials with no psychiatric background took a step back from these individual cases that more generalised knowledge about the mind of the colonial population could emerge.
  • Dr. Yasmin Shafei
    The history of mental illness and psychiatry reflects the multiple ways in which colonial governments and modern states have defined both their national projects and relationships with their subjects. This paper will explore how mental illness was constructed and understood during the first half of the twentieth century in Egypt. The study aims to interrogate the impact of nominal independence in 1922 on mental asylums and the mentally ill in Egypt. Focusing on the British colonial government as well as the newly-independent Egyptian state, the study explores differences in how both have appropriated mental illness and the impact this has had on psychiatric institutions and the patients institutionalized within them. As part of their administration of Egypt, the British systematically introduced specific doctrines for dealing with the medically insane. A psychiatric profession thus emerged similar to that in Britain, reflecting British medical practices and Victorian social values. Nevertheless, psychiatry in Egypt is much more than a foreign transplant and is also rooted in the country’s historical cultural beliefs. The blending of foreign ideas on mental health with Egyptian cultural traditions was part of a larger process in which foreign values at times merged with, and at other times were rejected in favor of, Egyptian beliefs and practices. With nominal independence came the “Egyptianization” of institutions previously administered by the British. One of the major changes that came with this independence was a transformation in the previous freedoms British doctors had enjoyed, and which enabled them to work rather independently. How was colonial psychiatry impacted by the growing nationalist movement in Egypt which resulted in nominal independence in 1922? What, thus, was the enduring legacy of colonial medicine and how was it reflected in Egyptian mental health practices? How did the management of the Cairo Lunatic Asylum of ‘Abb?siyya and the Kh?nkah hospital change as it was assumed by the Egyptians? Equally important, how did the treatment of the mentally ill differ from that which took place under colonial rule? The study will attempt to answer these questions by using archival material from both the national archives in Egypt and the United Kingdom, medical reports, correspondences, speeches, and journals. By juxtaposing British and Egyptian control over these institutions and analyzing the “Egyptianization” of the management of mental illness, this study will thus reveal as much about the differences between the colonial project and the Egyptian state as their similarities.
  • Dr. Beverly Tsacoyianis
    This paper blends medical, social, and cultural history approaches with anthropological and literary methods to analyze trauma, anxiety, and conflict in twentieth- and twenty-first century Lebanon and Syria. Based on evidence in psychiatric records, interviews, film, and literary sources, this research shows that biomedical and vernacular frameworks existed in tandem and often in tension with one another as the tumultuous events of the past 120 years (world wars, genocide, famine, regional wars, civil wars, sectarian conflict, brutal state repression, migration and refugee status) necessitated survival strategies that sought to cope with the ruptures of the past even as they produced or exacerbated ruptures in communities, families, and individuals. Informed by Franz Fanon's research on "reactionary psychoses" in 1950s and 1960s Algeria, as well as theories in trauma studies and religious studies, this research analyzes hospital records from the Lebanon Hospital (Asfouriyeh) as well as more than 100 patient case files spanning the 1920s to 1990s from Ibn Sina Hospital (in Douma) to complicate the binaries of "sane" and "insane", "modern" and "traditional", and "science" versus "superstition" in healing practices. I draw from data collected in numerous interviews with Syrian psychiatrists, psychologists, and faith-based practitioners conducted between 2008 and 2017 to support my argument to include faith (in treatment, in the relevant system, and in local communities) as a significant factor in choosing treatment options. Coupled with ethnographic data, political analysis (including from Raphael Lefevre's Ashes of Hama), film analysis (including from Lina Khatib), and works of Lebanese and Syrian semi-autobiographical historical fiction and journalistic accounts from female writers Alia Malek and Samar Yazbek, this analysis also reflects on the ways individuals perceive their sense of a ruptured self and ruptured nation as well as the gendered experiences of political upheaval and disrupted social order. The sources also suggest that individuals come to perceive various treatments differently during periods of intense loss of human life, as with the Lebanese Civil War and the current Syrian Civil War. While filmic and literary sources have acted as both a window and a mirror, collective amnesia, self-censorship, and disparate and conflicted community collective memories appear to manifest in both Lebanon and Syria as coping mechanisms that alternately re-traumatize, diminish the significant loss, marginalize specific non-normative identities or dissenting narratives of experience, and perpetuate the conditions under which new trauma may occur.