Medicine Anthropology Theory
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Normative Language and Judgements of Cognition: A Methodological Reflection on Difficult Sign Language Interactions
No full textIn this article, I investigate the case of a deaf woman, Silivia, who lived in western Uganda. Silivia did not use standardised sign language and was commonly considered to be ‘mad.’ However, some of her interlocutors disagreed, arguing that perceptions of madness arose because those around Silivia did not invest enough in attempting to communicate with her. I use experiential and analytical reflection on the methodological challenges of working with Silivia to explore what difficult moments tell us about how communication and everyday assessments of cognitive function are mutually implicated for deaf people in Uganda. Adopting a theoretical approach that understands languaging as a collective or distributed process, I argue that comprehensibility is not something that is determined by the qualities of a person’s expression, but rather something that happens to and through communication, mediated through social and environmental constraints. These include normative linguistic ideologies and frames of comprehensibility that may encode ableist expectations (for example, that ‘good’ communication is quick and efficient). In this context, I argue, interpretative difficulties that arise in the use of less conventionalised forms of visual languaging make some deaf people particularly subject to stigmatisation
Thinking Through Voice with a Somali (Love Doctor) Poet
No full textDuring research on love songs and political poetry in Somaliland, one of my closest interlocutors has been a poet named Weedhsame who describes his work as arising from a duty to ‘give voice to the voiceless’. Collaborating with a musician and singer to ‘give voice’ to otherwise mute love-sufferers, Weedhsame is revered as a ‘love doctor’ whose words provide therapeutic relief to his ‘patients’. His political maanso poems also powerfully ‘give voice’—sonically and textually—to the otherwise inaudible concerns of marginalised communities. My conversations with Weedhsame have provided me with a compelling emic perspective on what it means to ‘give voice’ to others, and the intimately social work of vocal mediation. They have also challenged me to think about my own anthropological voicing practices. In this reflection, I use my conversations with Weedhsame to consider the politics and practices of ‘giving voice’ in Somaliland, in matters of love and politics, before turning these lessons back on my own practice. I focus especially on what these practices might mean for how anthropologists gather, assemble and sound the stories and ‘voices’ of others in our work
Psychiatric Care as an Other-than-Human Entanglement: Anthropological Reflections on Forest Therapy
No full textWhat can we learn about the therapeutic landscapes of in-patient psychiatric care by focusing on the invisible, the seemingly unimportant? To explore how mental affliction and caregiving acts are connected to other-than-human dimensions and sensory experience, I analyse the role of trees and forests in a Swiss in-patient psychiatric clinic. Using ethnographic vignettes and introducing the forest as a therapeutic landscape, I discuss the role of trees in a ward’s day-to-day life, a psychiatric sufferer’s modes of self-perception in the forest, and a physiotherapist’s active ‘tinkering’. My central argument addresses a problematic element in the research on psychiatric care in Switzerland: it is largely devoid of anthropological attentiveness to sensory perception and the atmospheric. I propose an alternative view where the experiences of illness, recovery, and violence are fundamentally co-created by a sensory context—including its marginalised, nonhuman, and atmospheric dimensions—and a conceptual framework informed by an anthropological adaption of feminist notions of ‘matters of care’ as well as sensory and ecological anthropology.
Reconfiguring Psy Expertise in the Digital Age: Two Cases from India
No full textMental health platforms and apps provide technologies and techniques for self-work, diagnosis, and management of everyday crises. Therapeutic interventions designed to work outside the clinic, they distribute and reconfigure psy expertise. Using the cases of a chatbot-based mental health app and a digital mental health platform, both developed in Bengaluru, India, this article ethnographically attends to new forms of expertise that emerge within digital mental health ecologies. What does it mean when software specialists, AI programmers, or conversational designers emerge as novel experts in mental health care, along with psychologists? How do they build on or depart from more conventional forms of expertise? How is psy expertise enacted in these spaces? Psy technologists, I argue, engage conventional psy expertise, even while establishing their psy technological expertise as alternative, sometimes even superior, ways of responding to emotional crises and mental distress. I first turn to the ways psy technologists conceive of mental health as a technical problem, reconfiguring mental health expertise. Next, I delineate some of the practices through which they enact expertise: engaging (and contesting) psychological expertise and conducting clinical trials. Finally, I investigate what it means to care for mental health digitally.
Health-Related Expertise in the Digital Age: Reconfigurations and Redistributions
No full textSpecial Issue "Health-Related Expertise in the Digital Age: Reconfigurations and Redistributions", guest edited by Sandra Bärnreuther, Nolwenn Bühler and Giada Danesi
Of Ethnographic (Mis)Translations on a Ward
No full textIn this Field Note, I take the opportunity to reflect on some of the concrete dilemmas that I was faced with in trying to negotiate, secure and maintain access to my field-site. These reflections derive from my engagement with infectious diseases physicians, at a renowned corporate tertiary care hospital in Southern India, who are working towards mitigating antibiotic/antimicrobial resistance. By drawing on the difficulties of felicitously translating my concerns, as an ethnographer, to the epistemological universe that animated (but did not wholly determine) my site of investigation allows me to think through what might or might not emerge as strategically useful in the varied loci that anthropologists are increasingly engaged with.
Against Image Positivism: The Potentials for Play as a Mode of Health Research
No full textImages are increasingly used in health research as a complement to discursive methods, to elicit more and different types of knowledge and experience from participants. The use of image-based research, such as drawing and photography, then, holds promises for understanding health in new ways. However, such promises fall short when researchers and audiences treat images as realist representations of participants’ lives. Images are never clear representations of an objective reality- this is not their value either during or after research. In this photo essay, we show and discuss how we countered image positivism in the PHRAME study, Photographing Health by Rural Adolescents in the Midwest. The photos shown in this essay take viewers into our interviews in PHRAME and then out to our modes of audience engagement. Throughout, play served as a critical orientation and form of listening. We show this, first, through glimpses into our interviews, where we engaged in play that transformed meanings of photos taken by the young people. Then we show how we engaged public health, academic audiences, and popular audiences of the young people’s photos in play where audiences were invited to co-produce meaning through interactive activities, rather than reading to extract meaning from the photos. In conclusion, we suggest that play as a mode of research and exchange holds transformative potential, taking health research beyond the image positivism that has constrained the methodology to expand visions of what health is and might be.
Anthropology of Toxicity
No full textUncertainty, disavowal, forgetting, and stigmatisation are common responses to toxicity: dumping grounds are habitually portrayed as ‘strange, alien spaces with no comprehensive histories’ (Little and Akese 2024). How can we best face this strangeness? What are the methodological and theoretical tools we would need to do so? Three recent volumes offer provocations for anthropologists of toxicity from phenomenological, activist, and heritage management standpoints
Making ‘Setgel’s Creature’ Mindful: Conceptual Change in Contemporary Mongolia
No full textAs globally circulating understandings of mental health and mindfulness practices gain popularity in Mongolia, they articulate with setgel, a localised concept that has been shaped by a constellation of historical forces. Loosely translated as ‘mind’ in English, setgel has remained central to Mongolian notions of personhood, health, and civic duty, even as the meanings associated with those ideas have changed. As progressivist forces, Tibetan Buddhism and the dominant Soviet political culture of much of the 20th century have held and shaped values in public life. This Position Piece explores the role of power relations and political economy in changing associations of setgel through the example of a recent state-sponsored, Buddhist-inflected mindfulness promotional event for Mongolian influencers. It asks broader questions about how anthropologists as generators of ‘cultural’ knowledge attend to expectations from institutional hosts in the field while also maintaining fidelity to historical change in our work. 
Concerning ‘Neglect’: Perspectives on the Prioritisation of Mental Health Conditions in Protracted Displacement Contexts
No full text‘Neglect’ is a lucrative concept attracting billions of US dollars in research and development funding and transforming what is prioritised in global health. Stemming from a wider project aiming to improve healthcare at the intersection of gender and protracted displacement amongst Somali and Congolese internally displaced people and refugees, this article unpacks conceptualisations of ‘neglect’ in relation to mental health. Drawing on interviews with people with professional mental health expertise and/or lived experience of displacement, this article makes three contributions. First, we argue that ‘neglect’ must be considered in the context of competing health priorities and health-seeking behaviours, particularly given the additional challenges associated with disruption to social care networks in protracted displacement contexts. Second, we illustrate ‘neglect’ in light of our respondents’ distinctions between overt bodily expressions of distress that are socially disruptive and more internalised expressions of distress that are more socially containable. Third, we unpack the intersectional ‘neglect’ of women and girls by sexual violence’s distinctive confluence of social withdrawal with strategies of containment to avoid social disruption