I am asking this question to prepare for a seminar in the Division of Social and Transcultural Psychiatry at McGill University.
My seminar proposal is attached.
Your thoughts from all disciplines are most welcome.
- Vincenzo Di Nicola
I agree that there is a social agenda component. One of the goals of effective treatment of severe and persistent mental illness would be to prevent the "downward drift" seen in patients’ socio-economic condition. In a related situation, in advocacy we are often using economic data about days missed at work and lost productivity to try and justify the needed investment in preventing and treating severe and persistent mental illness.
A social agenda could come from groups outside psychiatry, and having nothing to do with authors' intention, (if they even had an agenda). The NAZIs in Germany took determined action on Depression-era editorials debating euthanasia for the very ill. It is VERY interesting to discuss this among psychiatrists from different cultures. I contrast APA Meeting anti-psychiatry protests in American cities (milling disorganized crowds of ill-groomed people wearing old clothes and bearing hand-lettered cardboard signs), and in Toronto when I was last there (an enthusiastic well-organized crowd with a Marching Band, and uniform printed T-shirts with the same slogan [PSYCHIATRY KILLS]; a celebration in the park across the street from the meeting hall. I did not give in to my temptation to go ask for a T-shirt, but I wish I had). US and Canada share much common history and culture, yet what a difference! I would love to attend your seminar. When will it take place?
To my readers:
There is an update on this question on this site, dated February 8, 2020.
This question will be discussed in depth at an upcoming seminar at McGill University's Division of Social and Transcultural Psychiatry on February 20, 2020 and will be available on the Transcultural Psychiatry Youtube channel. A detailed description is available in the attached files. Here is my abstract: Social and transcultural psychiatry, understood as a systemic understanding of historically and culturally situated relationships, the social determinants of health and their cognate approaches and studies, now compel psychiatry to consider the political. This seminar argues against the Western dichotomy since Aristotle of natural and political, private and public life, allowing the state to politicize biological life, creating a “biopolitics,” employing Giorgio Agamben’s historical-philosophical investigations. We will examine two figures in 20th century psychiatry – Frantz Fanon and Franco Basaglia – in their call for revolution and reform in psychiatry and society and contrast their positions with the political uses and abuses of psychiatry including Didier Fassin’s critique of humanitarian reason and Martin La Roche’s call for therapeutic activism. Finally, we conclude on the implications for a new politics and a new psychiatry.
Vincenzo Di Nicola
University of Montreal &
The George Washington University
William McDaniel:
Your comments are intriguing but I am not talking about a social agenda but an overtly political one. The name of the field IS Social and Transcultural (or more simply just Cultural) Psychiatry. Of course, one can argue about the borders and definitions of these terms. Let's say that in our current jargon I am addressing activism.
As Michel Uebel understood well, I am addressing theory not practice. I will discuss things that happen from a theoretical perspective. I know, I know ... everybody talks about it but nobody does anything. I am addressing this from a philosophical perspective and will studiously avoid partisan politics of any kind. Yet, your comparison of how protests work in the US and Canada bear much reflection.
By the way, I have visited the Scientology exhibits that routinely set up shop across or near the American Psychiatric Association Annual Meeting, wearing my APA badge. That is different, as I think you are suggesting, from people just showing up who are critical and dissatisfied with various aspects of psychiatry. I have also gone out to talk to them on various occasions.
Euthanasia has a long history in medicine, society, and politics and is sadly not limited to Germany and the Nazis. One source I can recommend is Stephen Jay Gould's "The Mismeasure of Man."
See my note above for the details of my seminar which will be available on Youtube.
Thanks for your reflections.
Vincenzo Di Nicola
University of Motnreal &
The George Washington Univeristy
It may be in the patient's interest to emphasize physiological treatment as "endogenous" Mental illness is similar in all humanity, similar to other illnesses such as cancer, etc. Differences in culture, and ethnic pools, such as the predominance of thalassemia in Greeks, economic inequalities, war traumas, and oppressive governments, may exacerbate or drive people to depression and mental illness. At the end of the day, biological causes are probably primary. There is always a risk that emphasizing cultural causes may become more political, less neutral, and less scientific.
Cultural considerations are palliative certainly.