Open Encyclopedia of Anthropology - Psychology

Affect

Rebecca Tishler — Wed, 26 Feb 2025 09:28:00 +0000

Detail of "The fallen Angel" (1847) by Alex Andre Cabanel, depicting the devil after being expelled from heaven. Picture by Wikipedia.

Daniel White Andrea De Antoni

University of Cambridge, Kyoto University

Initially published 26 Feb 2025

http://doi.org/10.29164/25affect

Abstract:

Affect refers to sensations and physiological shifts in intensity that may or may not formalise into conceptually distinct and collectively recognized feelings. Compared to emotions, which anthropologists see as feelings embedded in sociolinguistic concepts like love, anger, jealousy, han (Korean for sadness-grief), song (Ifaluk for justified anger), or hygge (Danish and Norwegian for cosiness), affects are conceived as more fluid. Although registered through biological and bodily sensation, affects are also culturally conditioned and can, in turn, strongly influence sociocultural dynamics. Anthropologists have long explored the varieties of emotional experience across cultures, from the analysis of different patterns of emotional behaviour in the early twentieth century to the linguistic comparison of different emotional expressions through the 1970s and 80s. Since around the 1990s, however, anthropologists began to shift their focus to the diverse ways that emotions also involve less linguistically determined but nevertheless socially conditioned bodily experiences they called ‘affect’. This entry documents early psychological and philosophical genealogies of affect; the relation of affect to anthropological studies of emotion; critiques of and counterpoints to the affect concept; and enduring themes in ethnographic studies of affect.

Introduction

An uneasy tingling of your skin when you pass through an unknown patch of forest; a sigh of comforting relief when you taste a familiar home-cooked dish after months away; the joyous energy of singing along with friends—word-for-word—the lyrics of a hit song; the high-intensity movements of a shamanic ritual; the low-intensity stillness of meditation; a dampness in the spleen; a longing in the heart; an ache. Many experiences are sensed but are not easily identified with a familiar emotion word like ‘fear’, ‘nostalgia’, ‘joy’, ‘transcendence’, ‘equanimity’, ‘worry’, ‘heartache’, or even ‘pain’. Moreover, feelings can often be surprising, arising at unexpected moments and carrying with them little indication of their origin or cause.

Although anthropologists have long been interested in these types of felt experiences, they have traditionally focused more explicitly on the public expression and symbolic display of feeling, which they called ‘emotion’. Since the 1990s, however, anthropologists in partnership with many others in allied social science and humanities disciplines began to explicitly emphasise the value of describing feelings that were sensed within and between bodies but did not always take linguistic or conceptual form. They called these ‘affect’.

Affect refers to a variety of bodily experiences, sensations, or simply perceived shifts in atmospheric intensities that, although conditioned through sociocultural environments, may not take form through culture-specific conventions and meanings. Despite their conceptual ambiguity, affects can feel sensorially distinct. They can feel strong, sharp, or subdued. Alternatively, they can also not feel like much at all, seemingly falling outside a person’s conscious perceptions. As an analytical concept, affect offers new ways to investigate what anthropologists have in the past variously referred to as ‘collective effervescence’, ‘sentiment’, ‘emotion’, ‘feelings’, ‘sensations’, and ‘the senses’. The broad semantic spectrum of these terms suggests not only that emotional experiences are diverse but so too are the conditions that shape them. The adoption of affect as a key conceptual tool was driven in part by a desire to address dimensions of experiences that eluded clearly circumscribed cultural frameworks and linguistic structures of meaning.

Affect theory brings together perspectives from psychology, philosophy, and several other fields such as gender studies, ethnic studies, and literature to explore the bodily and relational aspects of feeling. The following sections outline the development of the affect concept in anthropological theory. The first section traces influential genealogical roots for affect found within psychology and philosophy. The second highlights the relation between affect and earlier anthropological work on emotion. Section three evaluates critiques of and counterpoints to affect, given that the term is highly contested and debated within the emerging field of affect theory. The fourth section features distinctive features of the affect concept, and the conclusion considers enduring themes of affect studies, including implications for ethnographic method and disciplinary critique.

Psychological and philosophical forerunners to affect

Literature on affect in anthropology can be theoretical, abstract, and contested (see introductions to affect such as De Antoni 2019; Liljeström 2016; Rutherford 2016; White 2017). Therefore, it is helpful to outline key theoretical discussions in the past, which have traditionally emphasised Western traditions and that inform contemporary anthropological debates on affect. Two genealogies of this concept are particularly prominent, one psychological and the other philosophical. Each contributes distinct but complementary perspectives to shed light on how affect operates as an embodied and relational phenomenon. A common theme of this literature is a concern with how to relate somatic, or bodily, aspects of emotional processes (the ‘affective’) with its symbolic, conceptual, and representational components (the ‘emotional’).

Early psychological debates on affect adopted the worldview of Western science, which understood emotional energies as grounded in bodies and inherited through processes of evolution. As part of a natural continuum that humans share with non-human animals, according to Charles Darwin, emotional capacities could be identified through expressional behaviours, such as tendencies to bear one’s teeth when angry (Darwin [1872] 2018). This evolutionary view remained apparent in an early debate on the definition of emotion, which centred around a famous anecdote that questioned, for instance, whether fear is a condition that triggers one to run upon encountering a bear in the woods or is rather the post-hoc ascription of fear to an aroused body. Psychologist William James’ (1884) idea is that the ‘subjective experience [of sensations like] fear or disgust is the result of a process that unfolds after the alerting change in core affect’ (Beatty 2019, 202). In other words, although the common view sees emotion as a sensation that comes after one is ‘afraid’ (one sees a bear, becomes afraid, and runs away), James argued the reverse: that one is ‘afraid’ because of the physical experience of bodily sensations (one sees a bear, runs away, and finds oneself afraid).

These early debates on emotion became even more contested with the arrival of Freudian theory and the globalisation of discourses on instincts, Id, and the unconscious (W. Anderson, Jenson, and Keller 2011). With the spread of Freud’s idea that one’s psyche could be split between conscious and subconscious elements, scholars began to more commonly distinguish between feelings as containing both emotionally conscious and affectively un- or non-conscious components. Psychologist Silvan Tomkins (1962a; 1962b) expanded on these ideas, proposing a taxonomy of core affective instincts, such as interest-excitement, enjoyment-joy, or anger-rage. His work posited that while these states are universally shared, their expressions vary across cultural contexts. Early innovative essays in critical theory that began using the word ‘affect’ (Sedgwick and Frank 1995a; 1995b) revisited Tomkins’ theories, paving the way for a culturally oriented affect theory. For affect theorists today, this psychological lineage has inspired a set of questions focused on whether affect is universal or culturally distinct, to what degree it is grounded in bodies, minds, or both, and whether affect emerges before, simultaneously with, or after a conscious recognition of an experience of emotion.

Western philosophers also demonstrated an early interest in the relation between the somatic and ideological components of emotion. The philosopher Baruch Spinoza ([1677] 1994) defined affect (or what he called affectus) as the capacity to ‘affect and be affected’, a common phrase that many anthropologists would later cite. Spinoza described affect as ‘affections of the body by which the body’s power of acting is increased or diminished, aided or restrained, and at the same time, the ideas of these affections’ ([1677] 1994, 70, emphasis added). Spinoza’s view was that affect (bodily capacities) and emotion (‘the ideas of these affections’) are two dimensions of an inseparable single process, an argument which reflects his opposition to the mind-body dualism of his time.

Spinoza continues to inspire contemporary affect theorists who highlight the enduring open-ended, processual, and mutable qualities of the affective body as it exists in relation to different social and material environments. His ideas were rekindled in the widely read materialist philosophy of Gilles Deleuze, and popularised most prominently by the philosopher Brian Massumi (1995; 2002). From Massumi’s point of view, affect indicates pre-conscious modulations of ‘intensity’ moving through and between bodies (Massumi 1995; 2002). Emotion, on the other hand, is ‘qualified intensity’, its conceptual ‘capture’ in meaning, or the ‘socio-linguistic fixing of the quality of an experience which is from that point onward defined as personal’ (Massumi 1995, 88). From this perspective, affect could be understood as a kind of physiological flux of sensation that is registered in bodies and travels between them; emotion, on the other hand, is the conceptualisation of that sensation in a culturally shared and often linguistically coded meaning.

Within contemporary debates on affect, the philosophical idea that ‘arrangements’ (Slaby, Mühlhoff, and Wüschner 2017) of humans and non-human objects shape and are shaped by affect prior to affect’s capture in meaning became a popular and highly contested idea. Many contemporary scholars in the humanities and social sciences cite this particular philosophical genealogy of affect as influential, even if they are also critical of it (Ahmed 2004b; Berlant 2011; Berlant and Stewart 2019; Seigworth and Gregg 2010; Seigworth and Pedwell 2023). For example, some scholars argue that the terms ‘emotion’ and ‘affect’ identify qualitatively distinct experiences that follow ‘different logics’ and ‘pertain to different orders’ (Massumi 2002, 27). Other scholars see emotion and affect as existing along a continuum (Ngai 2005). Still others have proposed that the perception of an ‘affect-emotion gap’ is itself the product of particular discursive knowledge regimes, and varies based on different cultural, political, and socioeconomic applications of affect and emotion as technical terms (White 2017; 2022).

As a result of these debates, affect became a helpful conceptual lens through which ethnographers could focus attention on nuanced felt experiences that could exceed or precede cognition and language. It also provided a more fine-grained way to approach the contagious involvement and coordination of bodies that can be witnessed during rituals, political rallies, festivals, or in stadiums. In this regard, affect offered anthropologists more diverse and detailed perspectives on classic sociological theories of sentiment, such as Émile Durkheim’s notion of ‘collective effervescence’ (Durkheim [1912] 2008), which conveys a homogenisation of affects into one single group experience.

For example, ethnographic research on contemporary militarism in Pakistan demonstrates how the state can mobilise affect to sustain its authority over other political groups in society (Rashid 2020). Through a study of mourning rituals orchestrated by military personnel, anthropologists have shown how the military transforms grief into a resource for national solidarity. Ritual activities like public commemorations of martyred soldiers and state-sponsored funerals create ‘affective subjects’ who embody both personal loss and collective loyalty. Such examples show how affect operates not only as a homogenous collective force that can emerge through large-scale rituals but also as a constellation of complex feelings that can be specifically cultivated by certain social groups and selectively fostered or resisted by others.

Anthropologies of emotion

Anthropological work on affect builds closely on anthropological studies of emotions. These studies looked primarily to non-Western case studies of emotional experiences to examine how emotions varied from one context to another, providing evidence that challenged universal perspectives assumed by early research. Prominent works on this theme from the early twentieth century approached emotion as a marker of cultural difference. These works were influenced by psychological approaches and were later categorised under the label ‘culture and personality studies’. Representative studies depicted cultures as comparable through their dominant ‘patterns’ of dispositions, attitudes, beliefs, and personalities that make up a specific cultural entity (Benedict [1934] 2005). One influential study of the Japanese by Ruth Benedict, for example, juxtaposed individualistic ‘Americans’ motivated by emotional matrices of guilt and free expression with a more group-oriented ‘Japanese’, who were portrayed as motivated by shame, interdependence, and an obligation to different in-groups (Benedict [1946] 1974). In the case of interpersonal transgression, for example, ‘instead of accusing a man of being unjust, as an American would’, says Benedict, Japanese ‘specify the circle of behavior he has not lived up to’, and pointing to the particular ‘province’ or ‘code’ that was violated (195). Therefore, in cases of socially perceived bad behaviour, an American ‘may suffer from guilt’, whereas for ‘the Japanese’ ‘a failure to follow their explicit signposts of good behavior…is a shame’ (223–4).

In the 1970s and 80s, anthropologists reformulated these ideas of cultural difference imagined through constructs of emotion-based patterns and personality types, critiquing them as too rigid, culture-bound, and resistant to change. Instead, they focused on analysing emotional differences that could be observed through linguistic discourses and ‘emotional lexicons’ (Frevert et al. 2014). These anthropologists of emotion focused on cultural differences primarily by scrutinising emotion words in the languages of those they studied that did not neatly translate into English. This method offered insights into a broad human spectrum of emotional experiences existing both across and within different cultural groups.

For example, in a prominent 1980s study of the Ifaluk in Micronesia, based on fieldwork carried out in the late 1970s, anthropologists highlighted local words such as fago (loneliness/sadness) and song (justified anger) to build a critique of the ‘unnatural’ gendered division between reason and emotion in Western cultures (Lutz 1982; 1988). Other anthropologists working among the Pintupi of Australia examined emotions such as rarru (anger), which arose from threats to ‘shared identity or kinship’ (walytja) with others. These studies suggested that emotions emerge as semiotic—or meaning-making—practices rooted ‘in social life and its relationship to other signs’ (Myers 1988, 607). Among the Ilongot in the northern Philippines, strong feelings like liget resembled sentiments of anger and grief but did not have exact equivalents in Anglophone cultures, and appeared highly nuanced, complex, and variable (M. Rosaldo 1980, 1983, 143; R. Rosaldo 1989, 3; Spiegel 2017). These works demonstrated that emotions go beyond discrete bio-psychological categories and are embedded in social processes of language, meaning-making, and ethics (Lutz 1982; 1988; 2017).

Despite their innovative and nuanced approaches to emotion, some anthropologists perceived limits in what they saw as an increasingly outdated and culture-bound model of comparison. These critiques came in the wake of globalising processes that rendered the cultural boundaries of emotional words less distinct. Additionally, a theoretical turn in the 1980s emphasised a reflexive analysis of the Western literary conventions of anthropological writing, and challenged an ‘us-them’ model of culture (Clifford and Marcus 1986; Marcus and Fischer 1986). In light of their focus on culturally specific language and public symbols, previous studies of emotion were also criticised for overlooking aspects of bodily intensity that could exceed and confound language, potentially impacting bodies beyond conscious reflection.

These critiques grew throughout the 2000s, extending to disciplines beyond anthropology, and resulted in a theoretical shift away from the discursive dynamics of emotion toward sensations that did not neatly map onto emotional lexicons. Some scholars referred to this shift as the ‘affective turn’ (Clough 2007). Authors associated with this ‘turn’ sought to address more explicitly what language-centred analyses in the 1980s and 90s had partly and implicitly left out. Thus, affect theory provided alternatives to certain critiques made of the anthropology of emotion. Yet, it also became the target of new critiques, which argued that affect approaches overlook aspects of sociality in favour of describing bodily sensations, physiology, and abstract energetic processes of cultural dynamics.

Critiques of affect and counterpoints

With the rise of theoretical literature on affect, the term became increasingly targeted for critique and reformulation. For example, some critics took issue with an idea of affect as a field of ‘direct feeling’ that is supposedly distinct from the ‘conscious recognition’ of emotion (Ahmed 2004b, 39). They worried this approach risked universalising affect as a natural phenomenon disconnected from the socio-political forces that shape it. Related critiques argued that such a distinction even resembles a form of biological essentialism and reductionism, in which affect is treated as autonomous from ideology (e.g., Leys 2011, 2017).

Despite these on-going critiques of affect theory, some early studies of emotional and affective processes had specifically sought to show how social dynamics could shape physiological processes that were usually identified as purely biological or psychological phenomena. For instance, while a sensation such as pain may be commonly seen as an objective measure of a body’s biological response to a harmful stimulus, it can also be understood as operating through implicit value judgements of gender, ethnicity, and racial difference that ‘code’ pain in ways that register differently in the surfaces of skin. A study of an Australian government report on testimony of the separation of Aboriginal and Torres Straight Islander children from their families in Australia, for example, shows how historical narratives and contemporary legal practices can result in different effects upon the surfaces of bodies. While the report includes Aboriginal testimonies that read painfully to Indigenous communities, its suggestion that white Australians should acknowledge ‘national shame’ but not necessarily feel ‘personal guilt’ could be read as producing different affective results for readers with different skin colours: ‘Indigenous Australians tell their personal stories, but white readers are allowed to disappear from this history, having no part in what was done’ (Ahmed 2004a, 34–5). From this point of view, pain emerges as an immediate sensation, shaped through histories that read and feel differently for different people. Such studies show that ‘sensations are mediated, however immediately they seem to impress upon us’ (Ahmed 2004a, 30).

Although some studies like the above had directly addressed how bodily sensations could surface through social categories, other scholars still worried that broader trends in affect theory ignored how gender (Boler and Zembylas 2016; Thien 2005), ethnicity (Ramos-Zayas 2011), and racialisation (Berg and Ramos-Zayas 2015) shape and socialise affect. In adopting this perspective, affect theorists were entering territory covered by scholars of feminism, ethnic studies, and critical race theory. Some called for ‘critical examinations of “whiteness”’ (Berg and Ramos-Zayas 2015, 654) and sought to point out explicit examples from historical studies and queer theory that analyse the affective dimensions of racial dynamics. For example, historical studies of Latin American and Caribbean migrants in the United States have shown how certain depressive states were described by predominantly white mental health professionals through culture-bound taxonomies, such as familismo, fatalismo, or the ‘Puerto Rican syndrome’ (Berg and Ramos-Zayas 2015, 660; see also Muñoz 2006). Certain painful feelings tied to migration experiences, surfacing as uncontrollable screaming, trembling, or aggression in young women, were labelled as ‘abnormal’ and characterised through ethnic categorisations (Berg and Ramos-Zayas 2015, 660). Conversely, as other historical studies have shown, the perception of schizophrenia changed significantly in the 1960s from being seen as a ‘harmless’ condition primarily affecting white people to being viewed as a dangerous disorder characterised by anger and linked with the civil rights and Black Power movements (Berg and Ramos-Zayas 2015, 660; see also Metzl 2009). These studies show how institutional practices and ways of talking about race can condition negative affective states through racial frames.

Other critics argued that many affect studies ignored the role of history and place in conditioning affective responses, and offered compelling ethnographic examples as counterpoints. For instance, in a study on the ‘affective geographies’ of post-war Cyprus, after a 1974 partition of the island’s residents into a distinct northern Turkish-Cypriot and southern Greek-Cypriot territory, residents told stories of the melancholic feelings they encountered within ruined landscapes. Turkish Cypriots living in the abandoned homes of Greek Cypriots in the north faced an ‘atmosphere’ that ‘discharged a feeling of the uncanny, a strange feeling’ that was derived for some ‘out of a sense of impropriety, haunting, or an act of violation’ (Navaro-Yashin 2009, 11). Such studies raise the question of whether the feelings encountered in these landscapes are subjective, coming from the individual’s perception of a historically storied space, or the material environment itself, filled with abandoned objects and unkempt fields. Ethnographic evidence suggests that ‘neither the ruin…nor the people who live around it are affective on their own […] but both produce and transmit affect relationally’ (Navaro-Yashin 2009, 14). Detailed ethnographic studies of these socio-historical qualities of environments and space can help anthropologists unpack the multilayered impacts that some geographers have called ‘affective atmospheres’ (Anderson 2009).

Still other critics worried that philosophical oriented theorists of affect too heavily emphasise a ‘gap’ between the ‘signifying order’ and ‘affective order’; that is, between that which can be articulated and that which escapes linguistic expression (Martin 2013, S155; Ahmed 2004b; Berg and Ramos-Zayas 2015; Navaro 2017; Navaro-Yashin 2009). They wondered whether such a distinction was needed between emotion and affect at all. To this question, some of today’s affect theorists respond that neither early formative philosophical works on affect nor much of the affect literature that followed it subscribed to as hard of a break between affect and emotion as was characterised in some critiques of affect. As noted by Massumi in his popular work on affect, ‘The approach suggested here does not accept any categorical separation between the social and the presocial, between culture and some kind of “raw” nature or experience… The field of emergence is not presocial. It is open-endedly social’ (Massumi 2002, 9). Choosing to avoid this debate altogether, some scholars have advocated using the terms ‘affect’ and ‘emotion’ interchangeably (see Lutz 2017) or argued for ‘modal’ approaches that posit affect and emotion on a continuum, ‘whereby affects acquire the semantic density and narrative complexity of emotions, and emotions conversely denature into affects’ (Ngai 2005, 27).

Anthropologists of ‘embodiment’ have also contributed to discussions of how emotional and affective practices can exist along a continuum. These scholars argue that a focus on embodiment helps situate affect not as distinct from meaning-making processes, suggestive of body-mind dichotomies, but as something through which ‘dualities such as subject and object or meaning and the material world (evoking mind/body) can be collapsed’ (McDonald 2018, 187; also see Csordas 1990; 1993). For example, studies of exorcism rituals in Italy show how feelings and affects situated in embodied practices like prayer and touch constitute the basis for the experiential emergence of spiritual entities such as the devil. These felt experiences of the possessed person and the participants in exorcisms, in turn, contribute to the reality and the ‘capturing’ of particular entities into historicised, cultural structures of meaning—namely one demon or angel rather than another (De Antoni 2022). This ethnographically grounded approach to bodily feelings showcases what a focus on affect can offer anthropology.

Finally, some critics raised a methodological concern about philosophical descriptions of affect as an ‘escape’ from ‘perception’ (Massumi 2002, 36) or, in other words, as something that was difficult to articulate or ‘capture’ in language (see also Stodulka et al., 2019). For some ethnographers accustomed to describing their interlocutors through narratives, thinking of affect as that which always escapes its articulation has led to practical and methodological frustrations. It has also invited evocative experimental forms of writing about affect, such as works on everyday American life that attempt to capture the somatic contours of daily routines and ‘ordinary affects’ in poetic language that does not correspond to common analytical concepts (Stewart 2007, 1; also see Berlant and Stewart 2019). Many anthropological works on affect can be both highly theoretical and/or poetic in their approaches, and thus offer powerful insights through virtuosity in prose. At the same time, they can appear to some as overly abstracted from ethnographic contexts (Beatty 2019, 210–6). Thus, writing against the aforementioned critiques, many recent ethnographies analyse affect as situated in historical and cultural contexts (Ahmed 2004b; Berg and Ramos-Zayas 2015; Boler and Zembylas 2016; Muehlebach 2011; Muñoz 2006; Navaro-Yashin 2009; 2012; Newell 2018; Ngai 2005). Such works emphasise the simultaneously material, historical, social, somatic, and semiotic aspects of affect, and how these components relationally feed back into one another through dynamic ‘affective-discursive loops’ (Wetherell 2012, 7).

Indeed, some recent studies of affect have addressed the challenging question of how socio-material arrangements take on a force that is felt before it is conceived by revisiting classic arguments in social theory, such as in the popular discussion around mana (Mazzarella 2017a). Mana is a concept found throughout Polynesia that refers to a transhuman ‘force or efficacy’ that was ascribed to certain people or places that expressed palpable power and ‘vital energetics’ (Mazzarella 2017a, 1). Sociologist Émile Durkheim described mana as ‘at once a physical force and a moral power’ (Mazzarella 2017a, 1), resembling contemporary anthropologists’ interest in the relation between the emotional-conceptual and affective-somatic aspects of social processes. Such innovate reinterpretations of social theory show that what anthropologists today call ‘affect’ can be used to shed light on classic anthropological debates, resulting in a series of productive connections between anthropological studies of affect, emotions, mana, collective effervescence, and the ‘senses’ (Howes 2005; Pink 2009).

Advancing distinctive contributions of affect

Despite the many critiques of affect, including constructive suggestions to consider the overlapping territory between affect and emotion, there remain strong arguments for maintaining the distinctiveness of the term. For example, given that human acts of sensing or ‘feeling with the world’ (De Antoni and Dumouchel 2017) incorporate complex, fluid dimensions of both somatic and semiotic phenomenon, the word ‘affect’ can help disambiguate multiple processes. It can help anthropologists discern somatic processes that seem to function in part outside or below discourse more discretely, catalogue them more comprehensively, and add to ethnographic descriptions’ clarity, granularity, and sensitivity. This can sometimes require the modulation of the ethnographer’s own senses, which broadens previous conceptions of what makes for good ethnographic training.

For example, a case study of the French perfume industry demonstrates how affective capacities can develop through pedagogies of training, sensory exercises, and objects like an odour kit (Teil 1998). An odour kit is ‘made of a series of sharply distinct pure fragrances arranged in such a way that one can go from sharpest to the smallest contrasts. To register those contrasts one needs to be trained’ (Latour 2004, 207). In so doing, a perfumer, or an ethnographer studying perfume, must learn to ‘have a nose’ that allows one to inhabit a (richly differentiated odoriferous) world’ (207). New bodily capacities develop alongside encounters with objects that also operate affectively on the body. The result is that one develops a new, more discrete sensory capacity that at the same time unveils a more sensory-rich world particular to the modern French perfume industry.

Affect as a conceptual tool can also point to the experience of feelings that, while conditioned by cultural contexts, often misalign with or even challenge established cultural values. It can also help anthropologists articulate what happens in spaces of intimacy, whether of private homes or of selves, that do not fit—or fit only in queer relation—with established social values. In the Sindh Province of Pakistan, fakirs (meaning ‘beggars’ in Urdu and, in some cases, ‘transgenders’ in Sindhi) refer to persons who voluntarily take up poverty as a practice of ascetic devotion to Islamic saints, often motivated by ‘prophetic dreams and personal callings’ (Kasmani 2022, 8). Through devotional practices and mystical encounters with saints, some fakirs describe experiences of closeness and intimacy with saints that serve both as compelling testimonies of desirable affect for other ascetics and morally troubling stories for religious and political authorities. Thus, affects of ‘private feelings’ and ‘intimate relations with saints carry ramifications for broader regimes and critiques of power’ (10).

Another helpful approach to affect is a reflexive one, which subjects conceptualisations of affect, such as ‘the affect-emotion gap’ described above, to ethnographic observation. When doing so, it becomes clear how anthropologists’ practices of theorising affect can resemble those of their interlocutors. In national branding campaigns in Japan, for example, anthropologists noted how something like an ‘affect-emotion gap’ was also conceptualised by bureaucrats and national cultural policy makers. These officials observed an affective excitement among global consumers of pop-culture commodities produced in Japan and sought to convert it into an emotionally charged affinity for Japan itself. For example, through government-funded events promoting cultures of manga, to which many readers are attracted for its minor and counter-cultural themes, officials attempted to mainstream manga as a national cultural property of Japan. In this way, an increasingly global cultural commodity could be transformed into a potential national resource of soft power (Galbraith 2019; Leheny 2018; White 2022).

A similar process of gapping or splitting emotional processes can be observed within the global technological world of modelling affection, preference, and taste. For example, computer scientists at academic labs and corporate offices in the US who build taste recommendation algorithms for social media feeds presume that an affective appeal for a certain music style can be coded into numbers (Seaver 2022). Such a perspective splits a feeling of affection into the affective dimensions of personal experience and the emotional dimensions of ‘preference’ that can be computed. Similarly, engineers and computer scientists operating in the field of ‘affective computing’ (Picard 1997) at prominent labs at MIT and Cambridge rely on models that understand ‘affect’ as physiological changes in the body and ‘emotion’ as something codable in a machine system and translatable to humans interpreting those systems. Adapting work on affective computing to East Asian contexts, some robot engineers in Japan have experimented with building ‘affective engines’ into emotionally intelligent technologies, which could theoretically discern the affective states of people by reading the signal of an emotion, such as ‘happiness’, through the facial-expression recognition of a smile (see Fujita and Kitano 1998; White and Katsuno 2021; 2023). These examples illustrate how many specialists in the hard sciences are currently operationalising their own theories of affect to much greater impact than anthropologists. In fieldwork within rapidly changing technological worlds, the term ‘affect’ can therefore help anthropologists track significant transformations in the meanings, applications, and experiences of both human and more-than-human emotion.

Conclusions

As the above theoretical debates and ethnographic examples illustrate, studies of affect are diverse and contested. Nevertheless, enduring themes remain. Three are prominent. The first is the proposition that affect can point to feelings experienced beyond language or cognition—although not necessarily unaffected by them. Affect is indeed something more than just meaning. Rather, affect holds promise to add dimensionality to meaning, showing that meaning incorporates dynamic aspects of exchange between bodily experience and signification (Slaby and Röttger-Rössler 2018; Newell 2018; and Mazzarella 2009; 2017b). Affect points to somatic worlds in a way that is shared among others and consequentially entangled with semiotic concepts and conditioning. Bringing affect and semiotics together in this way can offer ‘improved understanding of both as the intertwined core of sociality itself’ (Newell 2018, 2).

A second enduring theme of affect is relationality. Although human bodies can be understood as individual sense-making and sense-registering entities, they are far from being merely an individuated product of established discourse. Rather, bodies can function as nodes that register, exchange, mediate, reciprocate, co-participate, and change in relation with other bodies or simply bodily parts—human or otherwise, living or inanimate (Navaro-Yashin 2009; Bennett 2010). This relationality of affect points directly to affect’s political dimensions and power dynamics, which incorporate aspects of race, ethnicity, gender, class, and several other theoretical concepts commonly used in socio-cultural anthropology (Berg and Ramos-Zayas 2015; Boler and Zembylas 2016).

Third, although affects may be distinguished by their uneasy alignment with conventional cultural categories, this by no means implies that affects are socially unconditioned. This point suggests that studies of affect hold potential to not only enrich previous anthropological studies of emotion but also to expand anthropologists’ understanding of the ‘culture’ concept on which the discipline still heavily depends. Through its ability to point anthropologists to the dynamic relation between public symbols and private feeling, the affect lens can unearth experiential dimensions of culture that have not been fully explored until recently.

Finally, beyond these enduring themes, affect may hold the greatest potential not in its theory-heavy analytics, which can draw disproportionately from the Western and philosophical traditions outlined above, but rather in its ethnographic applications in fieldwork. A growing collection of richly detailed ethnographies of religious practices, digital media, and human-nature interactions—many of non-Western contexts—show that affective practices exist in diverse and dynamic forms that don’t accommodate easily to established analytical theorising. For example, the deep cultivation of balanced states of feeling through Buddhist meditation in Thailand (Cook 2010); the pursuit of ‘queer companionship’ between Islamic saints and ascetics (Kasmani 2022); the mediation of the paranormal in Chile (Espírito Santo 2023); or the making of intimate and sometimes indifferent relationships with non-human others such as palms (Chao 2022), orangutans (Chua 2018; Parreñas 2012, 2018), mushrooms (Tsing 2021), and microbes (Benezra 2023): these innovative studies of affective themes diversify anthropology’s traditional understandings of culture; expand who speaks for and feels ethnographic knowledge; and offer reflexive resources for productively undoing and remaking the affective modes through which anthropological work is undertaken.

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Note on contributors

Daniel White is a research affiliate at the Leverhulme Centre for the Future of Intelligence at the University of Cambridge. His research examines emotion, politics, and emerging media technologies, with a geographic concentration on Japan and the Asia-Pacific. His recent book is Administering affect: Pop-Culture Japan and the politics of anxiety (2022, Stanford).

Daniel White, Associate Fellow, Leverhulme Centre for the Future of Intelligence. Level 1, 16 Mill Lane, Cambridge, Cambridgeshire, CB2 1SB, United Kingdom. Orcid ID: 0000-0003-2866-6587

Andrea De Antoni is associate professor in cultural anthropology at Kyoto University and Research Coordinator of the Italian School of East Asian Studies (ISEAS) in Kyoto. He specializes in anthropology of religion, experiences with spirits, spiritual healing in contemporary Japan and Italy, the anthropology of the body, affect, and emotions. He has published extensively about these topics in English and Japanese.

Andrea De Antoni, Associate Professor, Kyoto University, Graduate School of Human and Environmental Studies, Yoshida Nihonmatsu-cho, Sakyo-ku, Kyoto 606-8501, Japan. ORCID ID: 0000-0002-6480-0790

Editor:

Hanna Nieber

Dreams

Rebecca Tishler — Thu, 08 Aug 2024 03:17:37 +0000

Scene from a 2018 mural depicting dream creatures and the women who paint them, by Guatemalen artist María Elena Curruchiche. Picture by UN Women/Ryan Brown

Sophie Chao

University of Sydney

Initially published 8 Aug 2024

http://doi.org/10.29164/24dreams

Abstract:

Dreams are commonly defined as involuntary, sporadic events that occur to individuals during their sleep and that encompass visual images, cognitive activity, as well as a range of emotions, reactions, and sensations. Situated at the interstices of the real and the imagined, the meaningful and meaningless, the conscious and subconscious, and the sleeping and waking worlds, they have often been approached—if not always formally recognised—as sources of interpretive insight into the everyday lives, social relationships, psychological landscapes, and cultural worlds of those who experience them. This entry examines three prominent themes in the anthropological study of dreams as experience and dreaming as process. The first section considers dreams as manifestations of the subconscious and interior dimensions of individuals through the lens of ethnopsychology and attendant constructs of selfhood and identity. The second section considers dreams as cultural artefacts and practices through the lens of their ritualised or expert-led interpretation. The third section considers dreams through their relationship to religiosity, spirituality, and the transcendent, examining in particular dreams’ morality and function as sources of knowledge, divination, and power. The conclusion considers the methodological opportunities and challenges that arise in taking dreams seriously as objects of ethnographic analysis in light of the limits they appear to pose to the classical anthropological approach of ‘participant-observation’.

Introduction

There is perhaps no activity more private, individual, or interior than dreaming. Dreams tend to occur as involuntary, sporadic events during slumber, encompassing visual images, cognitive activity, and a range of emotions, reactions, and sensations. They are often remembered and recounted in scattered fragments or fleeting impressions rather than coherent or structured events. Their significance can seem glaringly evident, or thoroughly opaque. Some we deem meaningful, others trivial. Some dreams we are happy to share, others we would rather not reveal. Dreams, as such, sit somewhere at the interstices of the experienced and narrated, real and imagined, meaningful and meaningless, conscious and subconscious, and disclosed and concealed. Yet despite (or perhaps precisely because of) their nebulous nature, dreams have often been approached—if not always recognised—as sources of interpretive insight into the everyday lives, relationships, affects, and environments of those who experience them.^[1]

Dreams were long considered the primary terrain of psychoanalytic theory, which centres the role of unconscious mental processes in shaping human behavioural and mental states. Anthropological approaches have shed vital light on the socially and historically shaped ways that different communities understand the origins, causes, contents, contexts, and meanings of dreams, both as individual psychic experiences and as culturally situated practices, and in ways that do not necessarily correspond to scientific definitions (Lohmann 2007). The earliest reference to dreams within anthropology can be traced to the late nineteenth century scholar Edward Burnett Tylor (1871), who argued that dreaming, as a universally experienced state of reality-transcending and altered consciousness, enabled the emergence of human mythologies, cosmological frameworks, and religious beliefs worldwide. For Tylor, dreams in many non-modern societies were held to put people in touch with objectively existing souls or ghosts, while modern societies understood souls and ghosts to be the result of psychology and biology ([1871] 1920). His theories reflected a broader understanding among Victorian anthropologists that belief in the reality of dreams characterised earlier stages in the development of human society, within a three-part evolution of culture from ‘savage’ to ‘barbarian’ to ‘civilised’.

Early twentieth century dreaming studies, conducted primarily in non-Western settings and often tied to psychiatric interventions, tended to focus on the collection, classification, and comparison of similarities and differences in dream contents, or what was known as ‘dream data reports’ (e.g. Lincoln 1935).^[2]However, post-war scholars in psychological anthropology, and particularly those affiliated with the US-borne ‘Culture and Personality School’—an influential current concerned with how psychological and cultural forces shape human experience—were critical of the abstraction of dreams from their specific lived and interpretive contexts. They posited that dreams should instead be approached as expressions of collectively shaped personality traits and emotive dispositions shared by particular social groups (e.g. Eggan 1952).

It was primarily in the late 1980s and early 1990s that dreams came to figure more prominently as objects of ethnographic inquiry and cross-cultural comparison in their own right within the work of social anthropologists, some of whom bring their social scientific analyses into conversation with neuropsychology, evolutionary biology, and cognitive science (e.g. Nordin 2011; Laughlin 2011). Sometimes referred to as the ‘new anthropology of dreaming’ (Tedlock 1991), albeit not thoroughly systematised or integrated, this current recognises dreams as communicative events and legitimate modes of interpreting, inhabiting, and effecting change in the world. It draws attention to dreams as both interiorly experienced and culturally contextual social facts, often requiring multi-disciplinary analysis and attention to local psychodynamics. It also considers dreaming as a fruitful way to conduct research. Dreams can help build relations between field interlocutors and fieldworkers as dreamers themselves, allowing them to connect across different sociocultural worlds.^[3]

Drawing on ethnographic examples from diverse regions, this entry considers dreams as manifestations of the subconscious and interior dimensions of individuals through the lens of ethnopsychology and attendant constructs of self, personhood, and identity. It then approaches dreams as cultural artefacts and practices through the lens of their ritualised or expert-led interpretation. The third section examines dreams through their relationship to religiosity, spirituality, and the transcendent, examining dreams’ functions as sources of knowledge, divination, and power. The conclusion assesses the opportunities and challenges entailed in taking dreams seriously as objects of ethnographic analysis, particularly given their often-opaque nature and the limits they appear to pose to the classical anthropological method of ‘participant-observation’.

Self, identity, and psyche

Dreams play a central role within anthropological investigations into constructions of the self, identity, and psyche across individuals, collectives, and cultures, or what is referred to alternately as the field of ‘ethnopsychology’ (White 2012) or ‘cultural psychodynamics’ (Mageo 2015). Freudian psychoanalysis was instrumental in rehabilitating dreams as objects of legitimate scholarly inquiry and therapeutic intervention in the West and had a profound influence on early anthropologies of dreaming. Its influence manifests, for instance, in analyses of dreams as the disguised fulfilments of repressed wishes and as expressions of trauma, anxiety, and guilt. It also surfaces in the distinction identified by researchers between dreams’ manifest or conscious content and their latent or subconscious content, and an attention to the multiple symbolic valences of recurring dream motifs or patterns.

Exemplary of this approach is an ethnographic study conducted in the 1980s that centred on the dreams of Jovenil, a recently bereaved father among the Kagwahiv people of the Brazilian Amazon (Kracke 1981). In these dreams, Jovenil witnesses the engorged penis of a man that is snapped off as punishment for the man having slept with his own sister. Jovenil also dreams of suffering the wrath of his wife for inadvertently hunting and killing a monkey and of overturning a canoe that drowns his son, Alonzo. These events, according to anthropologist Waud Kracke, manifest Jovenil’s curiosity in the large penis of a fellow villager he beheld as a child and for which he was later castigated by his mother, resulting in sexual trauma. They also show his repressed guilt for engaging in taboo incestuous relations with a parallel cousin earlier in life, and the blame he places upon himself for the consequent death of his children as a form of punishment. In a society that prescribes that the dead must be forgotten and all memories of them eradicated, it was through the subconscious experience of dreams that Jovenil was able to work through the emotional process of mourning the loss of his children, facing his guilty conscience, and acknowledge his complicity in the tragedy.

If the example above centres on a single individuals’ multiple dreams, other early studies of an ethnopsychological bent took as their primary data a wider array of subjects and dreams to identify basic personality traits and worldviews that are shared by particular social groups, or what was then called ‘culture patterns’ (Eggan 1952, 478). For instance, ‘dream charts’ were deployed to analyse the manifest content of 334 dreams collected from men and women aged 6 to 75 years in Tzintzuntzan, Mexico (Foster 1973). Recurring symbols within these dreams, and particularly among men, include a threatening environment, impotence and loneliness, fear of embarrassment, and unpredictable futures. These repeated motifs point to anxiety over what people will say, or of being found out, as central dimensions of Tzintzuntzan cultural and gendered norms. They suggest that Tzintzuntzan people’s adherence to principles of good behaviour in waking life is driven less by their sense of guilt than by their conformity to what anthropologist George Foster calls a ‘shame culture’. Importantly, dreams’ manifest content directs attention not only to the basic tenets of ‘shame culture’ as a shared disposition among Tzintzuntzan people, but also to the disharmony or tensions that exist between this cultural ideal on the one hand, and the repression of desires that sustaining this ideal demands (Eggan 1952, 478).

More recent ethnopsychological scholarship has distanced itself from Freudian and Culture and Personality approaches to studying dreams. It recognised that such approaches risked being ethnocentric, i.e. that they often misinterpreted dreams because they stuck too closely to the cultural understandings of the analysts. Previous approaches had also assumed that cultures were largely static and that insights from one culture were widely generalisable. Working against these assumptions, contemporary ethnopsychological studies consider how cultural transformation, including processes of globalisation, colonisation, and modernisation, reconfigures the ability of individuals and collectives to reorganise their sense of self. They study, for example, how dreams that reflect back to the dreamer how their organisation of self relates to them, their body, and other beings and entities in the world (so-called ‘selfscape dreams’) relate to people’s interpretive frameworks (Hollan 2004). While such dreams may be universal in their basic orienting functions, their content varies within and across both cultures and individuals, conjuring cultural contexts that are more-than-local in their scope, sites, and subjects (e.g. Lattas 1993; Hollan 2005).

In American Samoa, for example, the dreams of young students, and their own reflections on these dreams’ significance, express their efforts to situate their selves in the context of imposed cultural shifts over a century of Christian conversion and Americanisation (Mageo 2004). In one such dream, a female Samoan’s muteness, compounded with her inability or refusal to speak either English or Samoan and her appearance as a White, blond-haired, blue-eyed three-year-old, point to communication problems, existential confusions, and forms of cultural resistance linked to Samoan girls’ shifting sexuality and gender roles. They reflect enduring traditional hierarchies on the one hand and notions of social equality and racial categories introduced by colonialism on the other. In another dream, the violent silencing and injury suffered by a male dreamer’s girlfriend embodies the challenge of reconciling the customary authority of higher-status Samoan males with the values of romantic engagement, care, and sincerity introduced by Christian missionaries, and American soldiers in WWI. In both instances, dreams and their interpretation by dreamers themselves come to constitute experiences that are creative rather than purely passive, conscious rather than purely unconscious, and generative rather than purely reflective. It is through these experiences that Samoans engage emotionally and discursively in the effects and affects of socio-cultural change and attendant forms of meaning-making.

Cultural artefacts, ritual acts, and interpretive practices

The sociocultural dimensions of dreams accrue particular prominence when dream ritualisation, communication, and interpretation form part of an established local knowledge system. Such insider or local knowledge systems offer valuable insights into how dream experiences are defined, classified, and valued across different communities as significant or mundane, empowering or perilous, or pragmatic or supernatural. They showcase how and when dreams should be communicated to others, or not, and who has the authority to elucidate their meanings. They also shed light on the diverse functions and causes of dreams, including as momentary and revelatory journeys deep into parts of the self or beyond (Mittermaier 2015; Groark 2009); as products of the intentions of the dreamer or unsolicited visitations by outside entities (George 1995; Heneise 2017); as pathways to or predicaments of past and future events (Stewart 2017; Basso 1987); as deliberately induced expressions of creative imagination or unwilled forms of external control (Herdt and Stephen 1989; Chao 2022); as guides to behaviour or reflections thereof (Ingold 2013; Pandya 2004); as experiences of diagnostic, therapeutic, anxiogenic, or punitive valences (Devereux 2023; Traphagan 2003); as expressions of resilience or rupture in the face of change (Graham 1995; Glaskin 2005); and as continuous extensions of, or radical breaks from, waking thoughts (Kracke 1981; Rubenstein 2012).

Ethnographic studies of dreams among the Yolmo of north-central Nepal illustrate the value of attending to local understandings of dreams’ sociocultural significance as categories of experience and modes of practice (Desjarlais 1991). According to one study, conducted in the late 1980s, dreams do not exist for Yolmo as a unitary entity, but rather in three distinctive forms—auspicious, inauspicious, and seemingly insignificant—that manifest in particular dream events. While villagers can articulate these basic distinctions, it is primarily Buddhist spiritual leaders and priests, such as lamas and shamans, who have the authority and expertise to determine what particular dreams signify and to heal those who experience them. They do so by drawing on a ‘dictionary of dream symbols’ (Desjarlais 1991, 215) that identifies and indexes a wide, complex, yet finite range of dream images and meanings that are collectively recognised but also vary in significance depending on the dreamer in question.

In contrast to the notion of dreams as reflective of the individual’s self, psyche, and past, many Yolmo believe that dreams predict events that will impact those around the dreamer in the course of their future waking life. For instance, a tree falling in one person’s dream indicates that one of their close relatives will imminently die (Desjarlais 1991, 216). Another key facet of Yolmo dream knowledge systems pertains to the sustained enculturation in editing, remembering, communicating, and thus in some ways creating dream stories that begin in the early stages of life. Throughout this process, Yolmo not only come to terms with the distresses expressed in their dreams, but also actively ‘make their dreams mean what they want them to mean’ (Desjarlais 1991, 221). What this study offers is an approach to dreams anchored first and foremost in the knowledge systems of dreamers themselves—one that uncovers dreams’ divinatory functions as well as their positioning with local structures of expertise, processes of skill acquisition, and understandings of meaning-making as a concomitantly symbolic and strategic endeavour.

Other ethnographic accounts attend the embodied and ritualised dimensions and protocols of dreams and dream-sharing as collective—rather than individuated—practices that serve to guide everyday social activities. One such case centres on dreaming among the Ongee people of Little Andaman Island and its role in determining communal hunting and gathering practices in daily life (Pandya 2004). Within these dreams, shared sensations of smells help to inform conscious and practical decisions by Ongee groups around what plants or animals should be sought out in the forest, where, and when.^[4]This olfactory dimension stems from the Ongee perception of dreams as moments where individuals’ internal bodies (enteeah) collect the smells left behind or imprinted upon their external bodies (mateeah) in waking life, in a process known as dane korale, which translates literally as ‘a spider making its web’ and is also the Ongee term for ‘dreaming’ (Pandya 2004, 143).

Ongee practice a ritualised form of dream-sharing by participating in lengthy and highly stylised discussions and singing before falling asleep on concentric and mutually facing platforms, in which they describe what they did in the day and what they dreamt of the previous night. Olfactory references identified across different individuals’ dreams, such as the smell of ripe jackfruit, bring these individuals to form groups and look for jackfruit in the forest together. The discovery of ripe jackfruit validates the dreams shared, producing what Ongee call ‘dream success’ (eneyemaga-tegebe) (Pandya 2004, 140). The collective, rather than individuated, nature of dream images and smells thus works hand in hand with Ongee’s collective interpretation of these dreams’ meanings and their implications for shared daily activities. While Ongee have since experienced a transition from circular open campgrounds to private enclosed quarters, and from forest-based subsistence to plantation labour, this ritualised, sensory, and collective ethos persists. People no longer dream or discuss the familiar scents of plants and animals. Instead, their collective dream-sharing rituals speak to experiences of, and guidance found in, the novel smells of plantation foremen and buzzing helicopters.

If symbolism and sensoriality play an important role within some cultural understandings of dreaming, other anthropological approaches invite a more radical appraisal of the primacy of acts and processes of interpretation. They focus less on the instances and categories of imagery and meaning and more on the activities involved in determining and consolidating dreams’ social significance. One example of this are the new dreams of ‘being eaten by oil palm’ (dimakan sawit) experienced by the Marind people of West Papua, Indonesia (Chao 2022, 183–200), wherein sleeping individuals become violently possessed by an introduced cash crop that is rapidly taking over their lands and forests in waking life. These dreams act as cultural critiques of the plantation as a newly established mode of economic production in the region, and they resonate with the new sensory experiences of Ongee community members.

Rather than focusing their discourses on the contents or events of these dreams, or attributing a therapeutic or cathartic value to dream experiences, Marind affirm it is primarily through the oral transmission of dream narratives to and with others that collective healing takes place. For instance, knowledge of kith and kin who have recently been ‘eaten by oil palm’ brings people to travel the landscape to their encounter. Shared dream experiences prompt villagers who are in conflictual relations over land rights to reconcile with one another, or enable starcrossed lovers whose marriage is proscribed by customary law to sustain a different kind of intimate relationship through dream story-telling. In contrast to traditional dreams, whose significance was arbitrated by medicine-men (messav) (Chao 2022, 188–9), new dreams of being eaten by oil palm are open to each and everyone’s interpretation, creating an egalitarian ethos that in turn allows for the participation of women, children, youth, and elders across rural and urban divides. What dream experiences mean, in other words, matters less than what dream sharing does as an exercise in mutual trust-building and as an acknowledgement of shared vulnerability to the attritive forces of plantation capitalism across waking and sleeping worlds.

Another example of how dream interpretation processes come to produce meaning, identity, and consciousness derives from studies of ‘dreamwork groups’ in the United Kingdom (Edgar 1999). These are groups in which six to twelve people share and interpret their dreams in a structured manner. Studying these groups showed that the ways in which dreams are discussed, embellished, and censored depend heavily on social and interactional group dynamics, such as their members’ degree of mutual familiarity, friendship, and shared values.

These dynamics produce dream interpretations that, over the course of conversations initiated by the dreamer but primarily shaped by the group’s questions, suggestions, reservations, and encouragements, become vastly different from the originally recounted experience of the dream and also mutate when dreamwork groups’ composition changes over time. It is through this situated and collective ‘cultural reworking’ of dreams (Edgar 1999, 39), involving the consciousness of both the dreamer and group, that new kinds of mental and affective connectedness are generated and the grounds for individual self-realisation actualised.

Transcendent encounters, spiritual power, and beyond-human knowledge

A third prevalent motif in the anthropology of dreaming pertains to its relationship to religiosity and the transcendent, notably as a source of cosmological knowledge, divination, and power across time. In some contexts, dream experiences and their revelations are intrinsically connected to spiritual understandings of consciousness, cognition, and salvation (e.g. Young 1999). In other contexts, dreams are seen as tied to prophetic figures and events in the past that in turn motivate religious and political movements in the present (e.g. Edgar 2011; Mittermaier 2011). Religious authority can be premised on the ability of select individuals to travel in time in the pursuit of sacred knowledge or to access extra-human powers and entities including spirits, gods, ancestors, and the deceased (e.g. Alatas 2019). Dreams may act as informal yet powerful ‘technologies of governmentality’ that self-regulate individuals’ conscience and conduct in everyday life (Eves 2011). They may also constitute sources of ‘liturgical novelty’ when creatively and contextually interpreted and acted upon by recognised experts (McGee 2012). While revelatory dreams may come to chosen humans through the agency of more-than-human beings, they can also be intentionally sought out and cultivated by human dreamers, including in the form of volitional or lucid dreaming, and through rituals, prayer, and trance- or vision-inducing substances, notably hallucinogenic plants (e.g. Hurd and Bulkeley 2014; Brown 1985).

One example of the cosmological and temporal dimensions of dreams is found among the Bardi Aboriginal people of the northwest Kimberley region of Western Australia (Glaskin 2005). As with many Indigenous Australian Peoples, the Bardi identify the creative period in the past during which ancestral beings gave shape to the world (or ‘Country’), as ‘the Dreaming’. Local terms for this period include buwarra, which translates as ‘dream’. While ‘ordinary’ dreams are experienced by ‘ordinary people’, particular individuals in the community, known as jarlngungurr (Glaskin 2005, 303), can communicate with ancestral figures, as well as the spirit beings and the deceased from the Dreaming. They do so through dreams that are initiated by these other-than-human beings and through which knowledges are revealed to the human dreamer. While these knowledges have existed since time immemorial, they inform contemporary ritual and ceremonial life in novel ways, including in the form of new songs, dances, designs, and more, pointing to the integration of tradition and innovation, and past and present, in both the dream form and its real-world ramifications. It is also through the knowledges acquired through dreams from spirits, ancestors, and the deceased that jarlngungurr are able to perform healing, divination, shape-shifting, and time-travel. Dreams thereby help the Bardi anticipate future calamities, notably where respect for Country has been violated and must be remedied or redressed.

As the example above demonstrates, dreams and their authority in producing truths play an important role in enabling the transmission of cultural and spiritual knowledge across times and generations. In other contexts, dreams have played a seminal part in encouraging societal transformation, notably in the form of religious enculturation and spiritual self-reinvention. This is the case among the Asabano of highland Papua New Guinea, for whom dreams (aluma) have always acted as portals to the dead, forest beings, or place spirits, and as experiential evidence through which people describe, explain, and rationalise their religious beliefs (Lohmann 2000). When Baptist missionaries sought to convert them in the late 1970s, many Asabano continued to practice their customary religion. It was only following a series of prophetic dreams experienced by villagers, in which they encountered God, the Holy Spirit, Jesus, angels, apocalyptic deluges, and the fires of Hell, that Christian beliefs were truly absorbed and internalised. Christian figures that appear in villagers’ dreams to this day testify to these beings’ reality and power and remind people of the behaviours they must sustain in order to secure an afterlife in paradise, whereas traditional and familiar dream-entities like evil nature spirits and cannibal witches are now interpreted as minions of Satan. As such, while the ability of dreams to convey information has not changed for Asabano, the kinds of information being received, and associated dictates of moral conduct, have significantly transformed, with dreams playing an important—potentially even determinant—role in enhancing villagers’ receptivity to the precepts of introduced Christianity.

Dreams, as such, can be instrumental in validating, inspiring, and sustaining belief among members of religious communities. Their evocative valences can also be harnessed beyond the scope of those individuals who adhere to particular religious groups, as illustrated by Amira Mittermaier’s (2015) reflective account of dream-stories among Egyptian adherents to the mystic body of Islamic religious practice known as Sufism. During her fieldwork, Mittermaier was granted permission by her interlocutor, ‘Umar, to consult and select accounts from the Book of Visions, containing the records of dreams and waking visions of followers of Shaykh Qusi, a renowned inheritor and transmitter of the prophet Muhammad’s teachings. This permission, she later found out, itself stemmed from an order that had come to ‘Umar by way of a dream. However, while Mittermaier originally chose dream-visions for her research with the aim of achieving a representative sample from diverse sources and encompassing diverse themes, ‘Umar replaced these selections with a collection of accounts that, to Mittermaier’s initial disappointment, were all relatively similar in content. What drove ‘Umar’s choices was not the pursuit of neutrality or representationality, but rather the effectiveness of these particular dreams in achieving the key aims of Sufi dream-visions—namely, to communicate the shaykh’s aura, to create a sense of awe, and to buttress the shaykh’s spiritual authority. Just as anthropologists selectively deploy ethnographic examples to convince and draw in their readers, so too Sufis approach dream-stories as invitations to their audiences that enable them to communicate and connect with the Prophet, his descendants, and the dead. Dreams allow us to catch a glimpse of the inaccessible, invisible, and unknown, and to be moved both spiritually and imaginatively. And just as prophetic dreams in Sufi communities are at once highly valued and contested, so too decisions around which dreams to include and exclude in Mittermaier’s ethnographic account were never neutral, but shaped as much by anthropological considerations as by the evocative use of dreams as examples by Sufis themselves.

Conclusions

Dreams are universal as experiences yet specific in their contents, interpretations, and performances. As such, they constitute powerful resources for engaging with long-standing questions around the construction of, and relationship between, self and society, mind and body, and continuity and change, and the meaningful slippages that arise across the realms of the known and speculated, lived and narrated, practical and spiritual, and agentive and reflective. Dreams express cultural creativity, social conflict, potentialities for self-exploratory, self-transcendence or hazardous vulnerabilities. They alternately reflect, resolve, or reinforce individual and collective anxieties and desires, as people move in and across different worlds, knowledges, and relations.

Importantly, attending to dreams anthropologically challenges the notion of a single ‘reality’ and its correlative relationship to the ‘imagination’ as the ‘broader range of meanings that encompass a variety of spaces, modes of perception and conceptualizations of the real’ (Mittermaier 2011, 3). Instead, it invites us to think of dreams as a form of ‘emergent reality’ (Tedlock 1987b, 4)—or as ‘real in a different way’, as Vincent Crapanzano’s Moroccan informant, Tuhami, says when speaking about his nightly visitations by a she-demon (1980, 15). Dreams are multiply meaningful precisely in light of their inherent ambiguity and in-betweenness, or what Jeannette Mageo calls their ‘mimetic incompleteness’ (2004, 151). They also draw attention to the political, affective, and social force of the imagination as a culturally molded yet never entirely graspable or intelligible dimension of human existence (Stephen 1995; Stevenson 2014). And just as not all dreams bear the same hermeneutic weight or consensual meaning for those who experience them, so too it is critical to consider whose dream interpretations are foregrounded within anthropological accounts across insider-outsider and subjective-objective divides.

Since its inception, the anthropology of dreaming has continued to develop in new and exciting directions. It is no longer confined to particular ‘culture complexes’ or world-regions. Instead, comparative studies of dreams across Global North and South divides push against the romanticisation or essentialisation of non-Western dream cultures (Domhoff 1990). These studies identify recurring motifs in the dreams of American and Japanese citizens (Griffith, Miyagi, and Tago 1958), the role of conflict in the dreams of Bedouin, Irish, and Israeli children (Levine 1991), and the manifest content of dreams experienced by US-based college women of Anglo-American, Mexican-American, and African-American heritage (Kane 1994).^[5]

Alongside a burgeoning of multi-disciplinary approaches that combine anthropological methods and theories with cutting-edge findings in neuroscience and evolutionary biology, some scholars are practicing ‘studying up’ by examining how Western-trained psychotherapists understand their own dream experiences alongside their relationship to both their patients and their profession (Dombeck 1991). Other researchers practice ‘studying in’ by harnessing auto-ethnographic methods to consider how dream-related knowledge systems learned in the field come to bear new meanings in light of their own personal, physical, and psychological traumas back home (Richman 2000). The role of animals as participants in and producers of dreams (Hallowell 1960) has seen renewed attention in emerging multispecies approaches that consider, for instance, dogs’ dreams as expressions of more-than-human perspectival agency (Kohn 2007) or the haunting apparition in dreams of wrongfully killed cows as expressions of more-than-human retributive justice (Govindrajan 2022).

At the same time, dreams continue to pose certain challenges to the classical methods of anthropology. ‘Dream-narratives’ are always fragmentary and often socially or individually motivated accounts of ‘dream-experiences’ (Kirtsoglou 2010) that themselves cannot be empirically verified and lie beyond the reach of participant-observation. The personal nature of dreams, as well as their at-times spiritual, sacred, or supernatural dimensions, can make them a sensitive topic of discussion, often requiring a strong level of rapport between the researcher and her interlocutors. Taking dreams seriously as objects of analysis is also not devoid of risk for anthropologists themselves, whose professionalism and objectivity may consequently come under question—notably when it comes to writing and imparting their own dream experiences (George 1995, 17–8).

And yet, attending to dreams can also open meaningful spaces for conversations around the different yet interconnected worlds of researchers and their informants. Participating in dream-experiences and sharing dream-narratives can drive intersubjective dynamics of fieldwork, and create mutual trust, critical self-reflection, and openness to ambiguity.^[6]As a form of affective and discursive ‘involvement in the cosmology of the Other’ (Sprenger 2010, 61), delving into dreams—both one’s own and others’—can push back on the ‘anthropological taboo against going native’ (Ewing 1994, 574) and attendant assumptions around the nature of cultural belief versus empirical reality (Luhrmann 1989; Favret-Saada 1980). Rather than dismissing dreams as fictive constructs or ethnographic objects alone, it is perhaps in anthropologists’ willingness to become vulnerable to dreams’ intersubjective thrust that dreams’ agentive force as ‘wild possibilities’ (George 1995, 17) might relationally and imaginatively gain ground and grow.

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Note on contributor

Sophie Chao is Lecturer in Anthropology at the University of Sydney. Her research investigates the intersections of Indigeneity, ecology, capitalism, health, and justice in the Pacific. Chao is author of In the shadow of the palms: More-than-human becomings in West Papua (2022, Duke University Press) and co-editor of The promise of multispecies justice (2022, Duke University Press).

[1] On the significance of dreams and dreaming in Western history from Ancient Greece to modern times, see Pick and Roper (2004); Parman (1991). On the role of dreams in medieval world religions, including in Europe, early Asia, and Latin America, see Shulman and Stroumsa (1999); Bulkeley (2008).

[2] These studies found echo in later approaches that were concerned with identifying constant and recurring motifs underlying diverse myths across different cultural settings (e.g. Kuper 1979).

[3] For state-of-the-field syntheses of the anthropology of dreaming, see Laughlin (2011); Lohmann (2019); the edited volumes by Tedlock (1987a); Bulkeley (2001); Mageo (2003); Mageo and Sheriff (2021); and the special issues edited by Stewart (2004) and Heijnen and Edgar (2010). For region-specific anthologies of dreaming, see Lohmann (2003) on the West Pacific; Jȩdrej and Shaw (1992) on Africa; Bulkeley (1994) on the West; Price-Williams and Degarrod (1989) on South America.

[4] On the function of dreams as techniques for solving everyday practical matters, including in the contexts of hunting, curing, craftsmanship, and artistic production, see Brightman 2002; Rushforth 1992.

[5] On anthropologies of dreaming in the Global North, see Hollan 2005; Newsom 2021; Heijnen 2010; Sheriff 2017.

[6] On dreams as an intersubjective research method in the field, see Chao 2023; Lambek 2018.

Editor:

Hanna Nieber

Mental Health

Rebecca Tishler — Tue, 04 Apr 2023 15:25:29 +0000

"Be happy and live". Photo taken in 2021 by photographer and mental health activist Damilare Adeyemi.

Mikkel Kenni Bruun

King's College London

Initially published 4 Apr 2023

http://doi.org/10.29164/23mentalhealth

Abstract:

When we talk about mental health, we could seem to be talking about some self-evident reality. However, the very notion of mental health can be seen to both assume and require a specific vision of human interiority. The so-called ‘sciences of the soul’—or the ‘psy' disciplines—were particularly formative in defining this perceived interior selfhood through various scientific and therapeutic practices of inspection and introspection, through new constitutions, articulations, and regulations of what it means to be human. Mental health could be seen to be fundamental to our collective and individual ability as humans to think, feel, relate, interact with each other, sustain ourselves, and enjoy life. This entry explores some key theoretical and ethnographic interests, and their alignments and tensions, through which different anthropologies of mental health have taken shape. For example, social studies of mental health have been shaped by various engagements of ‘culture’ as a form of both contextualisation and critique. More recently, scholars have examined the political, ethical, and therapeutic processes by which people come to constitute themselves and others—for instance, through everyday practices of self-care or clinical diagnosis and treatment—as particular subjects of mental health. Anthropologists have described how people’s experiences of mental health and its associated afflictions are constituted relationally, in different ways, and with different social consequences around the world. The entry ends with a brief discussion of some current topics in anthropological studies of mental health, from the proliferation of mental disorders and the prevalence of neurobiological understandings of human distress to the increasing digitalisation of mental health. As these and other efforts imply, mental health is becoming a prominent field of enquiry in contemporary anthropology and one with renewed ethnographic salience for everyone involved.

Introduction: Situating mental health

The concept of mental health has drawn together a range of ideas and practices that have come to define, and intervene on, what it means to be human. In contemporary English-speaking societies, it is a concept which is often used to express a concern for human well-being in psychological terms. However, what counts as ‘mental health’ is a question of varied social significance as we move historically and ethnographically across time and space. Increasingly, mental health figures as a universal feature in conceptualising humans, and, conversely, mental ill-health is understood to affect humans globally, with an estimate of 970 million (or 1 in 8) people around the world considered to be living with a ‘mental disorder’.^{^[1]}

Some anthropologists have argued that mental illness is recognised in every culture, even if the ways in which people experience, treat, and make sense of psychological distress might differ considerably (see e.g. Luhrmann and Marrow 2016). Others have been sceptical of the very language of ‘mental health’ and ‘mental illness’, particularly where it has been deployed to pathologise or criminalise incongruent desires and bodies, as in the case of homosexuality for instance (Foucault [1961] 1988a), and to uphold systems of colonialism and racialisation (Fanon 1963). At the same time, the concept of mental health construed as a shared human condition of what it means to be psychologically well has been deemed important and needed; indeed, mental health has in recent decades come to be regarded as a ‘human right’ by the World Health Organisation (WHO).^{^[2]} Increasingly across different social worlds, from local healing practices and national health systems to everyday affairs of care and kinship, global health discourses, and beyond, mental health has emerged as something that ‘everyone has’. It is something that, for better or worse, warrants attention and action.

This entry provides a brief exploration of some theoretical and ethnographic interests that have been particularly instructive in anthropological studies of mental health. Before turning to anthropology, however, the entry suggests a way of situating mental health. This can only be done in very general terms here. One important point is that, despite its contemporary ubiquity and salience, mental health is a relatively recent concept that emerged in particular historical (and historiographical) circumstances, shaped by new psychological practices and institutions, through which new constitutions, articulations, and regulations of a ‘healthy mind’ were effected. Modern psychology now generally considers people to have something called mental health located in the putatively subjective interiority of the individual person, a human interiority which has become aligned with particular notions of ‘the mind’ or ‘the brain’ (Martin 2021; Rose and Abi-Rached 2013).

The concept of mental health reveals a complex historiography of social transformations over the past two hundred years, from the era of the asylums to the psychiatric hospitals and mental health services with which we are familiar today (Foucault [1961] 1988a; Unsworth 1993; Shorter 2007). It is a concept shaped particularly by two world wars and the emergence of welfare states with the monitoring of publics and populations (Fraser 1984; Busfield 1998; Marks 2017). Importantly, ideas of mental illness have also emerged in contexts of colonisation and decolonisation (Reyes-Foster 2018; Calabrese 2013; see also Fanon 1963). The historical precursor to the concept of mental health has been traced back to the efforts of the ‘mental hygiene movement’ that took shape in Europe and America during the nineteenth and early twentieth centuries (Bertolote 2008; Novella and Campos 2017). The idea of ‘mental hygiene’ gained traction in the second half of the nineteenth century and is often credited to the work of William Sweetser (1797–1875), who defined it as the science of preserving a healthy mind (Sweetser 1850). The mental hygiene movement sought to establish public health measures and interventions in the prevention and treatment of mental disorders. In the aftermath of the Second World War, however, the term ‘mental health’ gradually replaced the language of mental hygiene because the latter had become increasingly associated with Nazi eugenics.

When we move to present-day contexts of the cognitive sciences, mental health figures as a wide-ranging field of research, with several scientific and clinical definitions currently in circulation. The WHO offers the following:

Mental health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community.^{^[3]}

The WHO states further that ‘mental health is more than just the absence of mental disorders’. Conversely, according to this definition, mental ill-health implies that a person lies at a ‘negative’ end of a health continuum. For instance, mental health professionals might speak of ‘caseness’, of being ‘a clinical case’ (see e.g. Susko 1994), which means that a person who reports distress considered as pathologically significant is deemed to be suffering from mental ill-health. We see here that the very conception of mental health hinges on one of the key problems in psychiatry, namely the epistemic resolution of the ‘normal’ and the ‘pathological’—including that distinction itself (Canguilhem [1966] 1989; Foucault [1963] 1973). The various ‘psy’ sciences (Rose 1985) that emerged over the course of the nineteenth and twentieth centuries established themselves by claiming their ability to deal with a range of mental and behavioural phenomena deemed dysfunctional or abnormal. The concept of mental health was thus historically constructed around notions of pathology and the differentiation between normal and non-normal conduct.

Anthropological trajectories

Contemporary worlds of mental health can be seen to constitute a multitude of sciences, technologies, and professions, as well as involve a wide range of therapeutics and care practices within and beyond clinical settings. In the following sections, we are going to look at some key anthropological trajectories in relation to what has been collectively termed the ‘psy disciplines’, that is, psychoanalysis, psychiatry, and psychology. Anthropologists have increasingly come to treat mental health as an ethnographic topic of central rather than tangential interest. This entry suggests that we might think of different anthropologies of mental health, some of which have developed within specific subfields of social and cultural anthropology, such as medical anthropology, psychological anthropology, and cross-cultural or transcultural psychiatry. Since the early twentieth century, anthropologists have developed diverse ways of studying issues that we might, for the moment, summarise as concerning ‘mental health’. However, this term—and other related terms such as ‘well-being’—came generally much later in anthropology.^{^[4]}

Anthropological research on mental health has often focused on traversing or reconciling the disciplinary fields of anthropology and psychiatry. One key aim was to render anthropological knowledge applicable to clinical problems. To some, this meant accounting for ‘culture’ in psychiatry, particularly in terms of ‘cultural difference’ in the perception and experience of illness, and in the classification, diagnosis, and treatment of people (Kleinman 1980; Littlewood and Lipsedge 1997). Within anthropology, it is largely medical anthropologists who have been at the forefront of dealing with these issues in the context of psychiatry—a discipline that has tended to dominate anthropological studies of mental health both ethnographically and analytically (see, e.g., Sapir 1932; Opler 1959; Westermeyer 1976; Kleinman 1988; Luhrmann 2000; Littlewood 2002; Brodwin 2013; Jenkins 2018; Pinto 2020).

Ethnographic fieldwork encourages us to take seriously the experiential realities of those we study. Anthropologists might not always find it appropriate, therefore, to assume a particular definition of mental health but tend instead to be more interested in how the people they study are establishing and enacting their own definitions and self-defining worlds: for example, how people might understand, use, resist, and live ‘mental health’, and the consequences. As such, rather than taking mental health for granted as pre-given or self-evident, we can think of it as something that emerges relationally. This entry suggests that mental health comes to figure in multiple ethnographic senses: as a presumed universal feature of the human mind; a sense of self; a psychological state that can be intervened upon and taken care of; a measure for populations, groups, or individuals; an object of therapeutic enquiry; a matter of concern for those classified as patients; and so on. We could talk here of different 'definitional realities' of mental health that constitute its meaning (see Ardener 1982; Hastrup 1995; McDonald 2020). For instance, clinical evaluations of mental health are inevitably dependent on the conceptual definitions offered of that reality. Analytically, this means that ‘mental health’ does not figure as an a priori phenomenon anterior to its relations and articulations, but as a category in action. Some social scientists might want to talk here about the ontological multiplicity of mental health; for example, how it is enacted and coordinated as a matter of concern—similar to the ‘doing’ of disease in medical practice (Mol 2002).

The ‘social’ and the ‘psy’

The question of mental health has been shaped by various attempts to either separate or reconcile the social and the psychological. Such attempts were particularly influenced by anthropological studies of the so-called ‘primitive mind’, the 'personality of culture', and the nature of human cognition. Anthropology addressed mental health as an object of study, in an important sense, via the scientific ambitions of the early psy disciplines, notably late-nineteenth-century and early-twentieth-century psychoanalysis and experimental psychology. Yet mental health was often only implicitly dealt with, eclipsed by prevailing ambitions at the time to ascertain a universal human psychology—‘the generalised mind’—inspired in part by the German experimental psychologist William Wundt’s (1832–1920) ‘introspective’ methods, as well as by subsequent anthropological investigations into what was then seen as the ‘primitive’ or ‘savage’ mind (Martin 2021, 26–51; see also Rieber 1980; Mandler 2011). Influenced by Darwinian evolutionism and its underbelly of Victorian scientific racism, a widespread theory of human psychology claimed that so-called ‘primitive’ people lacked higher mental functions while they surpassed ‘civilised’ people in physical performance, because more energy was seen to remain devoted to their physicality as opposed to their mentality (Martin 2021, 37). This theory was put to test, and eventually challenged, by the 1898 Cambridge Anthropological Expedition to Torres Straits (Haddon 1901; Herle and Rouse 1998; Sullivan 2012), which also sought more generally to investigate psychological ‘introspection’, namely the inspection of one’s own internal mental processes. The expedition was influential in shaping both modern anthropology, and in bringing together psychology and anthropology with a common interest in what we might now want to see as an early version of mental health research.

However, the relationship between anthropology and psychology as exemplified by the Cambridge Expedition did not end in a happy marriage. On the contrary, in Britain and elsewhere, the social and cultural were in many ways further delineated in contradistinction to the psychological. During the early twentieth century, new disciplinary identities emerged as practitioners marked out social science (including anthropology) distinct from psychology and natural science. For example, the British anthropologist Edmund Leach treated psychology as a discipline against which social scientists are ranged. He asserted that ‘[the anthropologist] will be well advised to leave psychological matters to psychologists and stick firmly to the public sociological facets of the case’ (1958, 148). This was a disciplinary division of labour according to which the world was also divided into a presumed separation of the public and private, the collective and individual, the external and internal. One of the pioneers of British social anthropology, Bronisław Malinowski (1884–1942) effected his own disciplinary boundary-making by way of critically engaging with psychoanalysis. In Sex and repression in savage society (1927), Malinowski famously examined the Freudian ‘Oedipus complex’ in the context of Trobriand kin relations and child development, which led him to dismiss any notion of Oedipal universality claimed by psychoanalysts of the day. While Malinowski remained a critic of psychoanalysis and its ‘exorbitant claims’ throughout his career, he also contended that its ‘open treatment of sex […] is of the greatest value to science’ (Malinowski 1927, vii–viii). Although Malinowski and Leach, and, before them, Émile Durkheim ([1912] 2008), had long moved the ‘social’ away from the ‘psy’, the question of human interiority—for some the seat of cognition, emotion, and subjectivity, complete with an individuated mind or consciousness (indeed, what many today might think of as pertaining to mental health)—never completely disappeared from anthropology.

Influenced by the work of Franz Boas (1858–1942), another famous anthropological pioneer, developments in American cultural anthropology during the first half of the twentieth century offered a rather different engagement of psychological theories. The most prominent development came from the ‘culture and personality’ movement during the 1920s and 30s instigated by the work of Edward Sapir, Ruth Benedict, and Margaret Mead (all former students of Boas) and which subsequently fed into the American-bred field of psychological anthropology (Ingham 1996; LeVine 2010; see also Mead 1928; Sapir 1932; Benedict 1934). Applying their own critical reading of Freudian psychoanalysis, they argued that human behaviour is ‘culturally patterned’, just like speech is patterned by a particular language. The cultural patterns of childhood experience were thus considered to be the cause of adult personality characteristics, which in turn gave rise to culture-specific patterns of mental health and forms of psychopathology. The aim was for some to develop a generalised cultural description of mental health through ethnographic research on individual personalities and, by extension, the personality of cultures. For other anthropologists, however, such an ambition simply confirmed what they had previously suspected, that a psychologised version of anthropology was susceptible to reductionism and overgeneralisation (LeVine 2001).

It was only much later with the ‘cognitive revolution’ of the 1970s, that ‘psy’ gradually came to occupy another conceptual space among anthropologists as they began to move from the mythic and symbolic universe of structuralism (owed to the work of Claude Lévi-Strauss, and those who read him, see e.g. 1963) to the laboratory of cognitive science. New evolutionary theories equipped anthropologists with novel rethinkings of ‘cognition’ (e.g. Bateson 1972) that shaped the emerging subfield of cognitive anthropology (Blount 2011). Importantly, some anthropologists challenged what to them appeared to be their discipline’s ignorance of a properly scientific study of human mental life. Cognitive anthropology sought to put an end to the Durkheimian separation of the social from the psy that had informed so much of anthropology. However, mental health was still largely a taken-for-granted object in cognitive anthropology, which has tended instead to examine the transmission of cultural representations, Theory of Mind (ToM), innate modularity, and cognate ideas (see Whitehouse 2001; Bloch 2012; Irvine 2018). In all such endeavours, and in those that have come after, the concept of culture looms large.

Culture and mental health

Anthropological studies of mental health in the second half of the twentieth century have been driven by efforts to account for ‘culture’ and ‘cultural differences’ that came out of interdisciplinary borderlands between psychiatry and anthropology, sometimes referred to as ‘cross-cultural’ and ‘transcultural’ studies (cf. Opler 1959; Westermeyer 1976). Culture was also taken up as a language of anthropological critique. For example, the psychiatrist-cum-anthropologist Roland Littlewood has argued that the concept of culture remains ambiguous for psychiatry as it has tended to perceive it as secondary to a biomedical reality. He argued that psychopathology is inherently ‘local’, and that the discipline of psychiatry has its own tacit ‘culture’ (Littlewood 1996). Earlier work had already introduced the idea of ‘the cultural construction of clinical reality’ and encouraged ‘a clinical social science capable of translating concepts from cultural anthropology into clinical language for practical application’ (Kleinman, Eisenberg and Goods 1978, 140). Its authors urged a distinction between ‘disease’ and ‘illness’, as well as the concept of ‘explanatory models’ that sought to include and elicit the ‘patient’s experience’ of disease and treatment: how do people understand and live with mental illness? How is disease perceived in cultural terms? What or who caused it, and how? This work seemed in many ways novel and important, but it still took for granted many of the old dichotomies of medicine. For instance, Kleinman and his colleagues presented a scenario of doctors with scientific ‘knowledge’ and patients with culturally determined ‘beliefs’; with ‘disease’ (medical reality) on the one hand, and ‘illness’ (cultural experience) on the other.

The disease versus illness distinction has informed much research in the intersecting fields of anthropology and psychiatry, as well as beyond: it is now a common component of clinical education programmes where it features as a way of reinserting ‘the cultural context’ where such is deemed lacking or to acknowledge ‘the patient perspective’. Yet this conceptual binary can also imply a problematic separation of the physical versus the mental whereby the former is seen as underlying (biological) causation and the latter as mere (cultural) representation. This has tended to presuppose that neurobiology—as a seemingly culture-free reality—is the ontological foundation of mental health upon which perceptions and experiences of it are culturally or socially constructed. We can trace many contemporary versions of this type of social and cultural constructionism in anthropologies of mental health and related fields.^{^[5]}

The earlier work of Kleinman (1980; 1988) along with the anti-psychiatry movement of the 1970s (e.g. Szasz 1974) nevertheless had a significant impact in confronting psychiatry with ‘culture’, although their reasons for doing so differed greatly: anthropologists generally sought to improve psychiatry rather than dismantle it. Even so, anthropologists now seemed equipped to take apart the cultural preconceptions built into psychiatric diagnoses and treatments in a manner that exposed psychiatric conceptions of mental disorder as inherently ethnocentric, revealing underpinning cultural biases and assumptions (Littlewood and Lipsedge 1997). Anthropologies of mental health and illness have since been routinely embedded in constructs of ‘cultural difference’ or ‘different cultures’ (e.g. Littlewood and Dein 2000; Luhrmann et al. 2015; Onchev 2019). The language of culture has also been considered a worthwhile mode of contextualisation in a field of research that still tends to be dominated by biological determinism (e.g. Sargent and Larchanché 2009). Some anthropologists have found it compelling to talk of ‘the culture’ of the mental health clinic (Luhrmann 2000, 119–57); of differences in professional and therapeutic cultures, with diagnosis, treatment, and patients recontextualised. More recently, new interdisciplinary engagements between anthropology and psychology have described how different cultures ‘invite’ people to relate to their mind in particular ways, which in turn affects the kinds of mental experiences people have and how they make sense of them (Luhrmann 2020; Weisman et al. 2021). Understanding mental health here means grasping shifting cultural models of mind.

Historically, anthropologists have thus been largely responsible for introducing the concept of culture to the study of mental health (cf. Mead 1953; Opler 1959; Westermeyer 1976), although it did not always bring about the anthropological insights that occasioned it. For example, ‘cultural competency’ now regularly features as an important educational component of many mental health training programmes and services (e.g. Carpenter-Song, Schwallie and Longhofer 2007). But cultural competency efforts, despite their best intentions, can appear to treat culture simply as a variable to be accounted for. Different differences—what might be seen as pertaining to nationality, gender, ethnicity, race, and sexuality—are often brought together under a single denominator of the ‘cultural’, thereby eliding a range of experiences altogether.^{^[6]}

The concept of culture has in many ways effected its own problems. Introducing ‘culture’ in studies of mental health, as suggested above, meant introducing ‘context’ and then ‘meaning’. Yet, in these instances, culture is easily reified in ways that some anthropologists might find rather problematic (Strathern 1995; Fox and King 2002; McDonald 2012). For example, speaking about different cultures of mental health might imply an unhelpful normativity that requires further anthropological validation, and evoking culture as a mode of contextualisation and critique does not always differ significantly from people’s own self-understanding. Whitney Duncan (2017) explores this latter point in her ethnography of psychoeducation (psicoeducación) in Oaxaca, Mexico. Working with psychologists and patients in and around a psychiatric hospital, she describes how mental health practitioners come to understand culture as a barrier to mental healthcare. They strive to further ‘psy-globalisation’—the transnational flow of ideologies and practices around mental health. Practitioners see themselves as involved in a global and modernising movement to promote mental health but express frustration about how difficult this project is in Oaxaca, where ‘local culture’ prevents their efforts (Duncan 2017, 37). Mental health practice thus emerges as a project of what she terms ‘psychological modernisation’, a movement that is defined against its own perception of local culture (consisting of ‘traditional medicine’, ‘beliefs’, and ‘magical thinking’). It considers local culture to be incommensurable with global notions of mental health and a source of resistance to mental healthcare and its de-stigmatisation. Not only does psychoeducation in Oaxaca provide a means of self-understanding among professionals and patients alike in the context of modernity, Duncan argues, but it also actively seeks to produce the psychological conditions for modernity.

From governmentality to self-cultivation

Michel Foucault (1926–1984) has arguably been one of the most influential scholars in social studies of mental health and illness. It was the earlier body of his work on the history of madness and the birth of the clinic (Foucault [1961] 1988a; [1963] 1973) which initially inspired critical examinations of the psy disciplines—speaking of a ‘great confinement’ of the mad into asylums and new scientific ambitions that effected the authority of a ‘medical gaze’ (e.g. Hacking 1998; Rose 1989; Danziger 1998). These accounts have traced how, over the course of the twentieth century, psychological knowledge regimes have effected new forms of self-governance—what Foucault called ‘governmentality’—and political relations. The insight that whole populations and ‘life itself’ have become problematised as objects of management and regulation gave rise to the terms ‘biopower’ and ‘biopolitics’ (Foucault et al. 1991; Rose 2006).^{^[7]} In the formation of (neo)liberal democracy, Nikolas Rose (1996) has shown that diverse psychological knowledge practices require that we ‘invent our selves’ or constitute ourselves as if we were selves. The crux of the arguments that run through much of this and related Foucauldian scholarship is the contention that, in the name of expertise and well-being, the psy disciplines—their institutions, professions, technologies, and interventions—conceal and instil specific moral and political ideologies that shape the ways we come to know, relate to, and act upon ourselves and others. Constituted through discourses of individual autonomy, people are rendered responsible for their mental health—for instance, in everyday articulations and requirements ‘to take care of yourself’—in the name of their own freedom.

Anthropologists of mental health have also drawn from Foucault’s work on ‘subjectification’ (assujettissement) in examining the different modes and processes by which human beings are made into subjects. Subjectification refers not only to a mode of having power and control exercised over oneself (‘political subjection’) but also to modes of acting upon oneself and others that constitute one as a particular kind of subject (Foucault 1997). When applying this analytical lens to mental health, it can elucidate, for instance, the effects of people subjected to practices of diagnosis and treatment by which they are classified as distinct clinical cases (e.g. ‘a patient with anxiety disorder’), at the same time as they are required to take up particular subject positions (see Hacking 1985, on ‘making up people’). Consider as example the construction of ‘post-traumatic stress disorder’ (PTSD). Based on Vietnam War veterans’ reports of war-related trauma, PTSD was officially accepted in 1980 as a universal disorder, when it was included in the third edition of the American Psychiatric Association’s Diagnostic and statistical manual of mental disorders (DSM-III). This followed a political struggle by psychiatric workers on behalf of the large number of veterans who were seen to suffer from the psychological effects of traumatic memory (Young 1995). Contrary to the depiction of the disorder in psychiatric classification practices, PTSD may thus not be timeless, nor does it possess an intrinsic unity:

Rather, it is glued together by the practices, technologies, and narratives with which it is diagnosed, studied, treated, and represented and by the various interests, institutions, and moral arguments that mobilised these efforts and resources’ (1995, 5).

Young shows how clinicians in the US applied the diagnostic criteria to include people that they felt ought to be seen as mentally ill and shows the way patients in turn began to present themselves in such a way as to fit into the diagnostic categories of PTSD.

Moreover, some scholars have argued that psychiatry’s capacity to define the ‘mentally ill’ has been achieved partly through the making and remaking of the DSM (American Psychiatric Association 2013)^{^[8]} and through historical processes of institutional colonialism, market capitalism, and a medicalisation of human suffering (see e.g. Healy 1997; Kirk and Kutchins 1997; Borch-Jacobsen 2012; J. Davies 2021). This literature targets modern psychiatry and pharmaceutical industries in particular, and has echoes of earlier critiques that came out of the anti-psychiatry movement of the 1960s and 70s (e.g. Fanon 1963; Szasz 1974). This was a movement influenced by Foucault’s genealogy of madness, which appeared to expose psychiatry in many ways as a structural oppressor. Foucault’s scholarship thus had a significant impact on intellectual anti-psychiatry critics, many of whom held academic positions in psychiatry, although he often distanced himself from the direction in which they took his work.

Since the 1980s and 90s, then, social scientists have been ready to contextualise and deconstruct mental health within an analytical frame of ‘politics’. Neoliberalism—with its associated ideals of autonomy and individual responsibility (Ganti 2014)—has often been evoked as one such political frame within which to locate and critique mental health. Social scientists have pointed to the impact of neoliberal attitudes on social and economic stressors such as unemployment in relation to the rapid increase in ‘mental health problems’. Neoliberalism especially shapes depression and the growing ‘happiness’ industry (W. Davies 2015). At the same time, even putatively ‘neoliberal’ mental health initiatives might be seen to move beyond political agendas and logics with unexpected consequences. For example, some anthropologists argue that the self-governing practices of individuals required to ‘work on’ their mental health—and any process of subjectification this might entail—are not always sustaining any straightforward or self-explanatory neoliberalism (Cook 2016; Bell and Green 2016). It has also been common in social science studies of mental healthcare for ‘politics’ (neoliberalism or capitalism, for instance) to be seen and cited as a domain that gets in the way. By the same token, one common way of criticising care has thus been to situate it in the service of politics.

T.M. Luhrmann’s (2000) ethnography of American psychiatrists can be read as an objection to the kind of critical studies of the psy disciplines discussed above. Luhrmann refrained from situating her study of American psychiatry in terms of Foucauldian governmentality, deeming such social science perspectives a naive romanticism that does little justice to the suffering subjects:

Foucault did presume that madness had always existed, but he romanticised it in a way that, despite all his insights, did a terrible disservice to its pain. […] Madness is real, and it is an act of moral cowardice to treat it as a romantic freedom. (2000, 11–2).

Instead, Luhrmann identified two competing paradigms in psychiatry: the psychotherapeutic model (informed by psychoanalysis and psychotherapy) and the biomedical model (informed by neuroscience and pharmacology). Her ethnography provides a remarkable account of the epistemological conflicts between ‘talk therapy’ and ‘drug therapy’, and the medico-moral consequences of losing the former to the latter.

More recently, it is Foucault’s later writings on ethics and care (see e.g. [1978] 1988b; 1997) that have inspired anthropological perspectives on mental health. People who undergo mental healthcare, for example, can be understood as participating in active processes of self-cultivation through an ethical practice of ‘reflective thought’ (Laidlaw 2018). Here, one’s mental health is constituted as an object of reflection in order to change it, or one's relation to it. Practitioners of ‘mindfulness-based cognitive therapy’ develop a particular ‘distanced perspective’ as they are learning to cultivate a detached relation to thoughts and feelings: ‘I have thoughts, but I am not my thoughts’ (Cook 2015, 223–9). This seeming capacity for introspection, to take one’s ‘self’ as an object of inspection and reflection, is at once assumed and required in psychological therapies as practised in the UK and elsewhere (Bruun 2023). In the face of the promise of postsocialist democracy, the work of post-Soviet Russia’s psychotherapists can be understood as an ethical practice of freedom, but one that ultimately hinges on ‘an ongoing struggle between different assumptions about freedom […] that plays out through precarious care’ (Matza 2018, 241). The freedoms sought in post-Soviet Russia are less individualised and based instead on collective forms of ‘self-work’. Psychotherapists seek to cultivate mental health for themselves and their clients but are caught between psychology’s ambiguous care for the lives of two distinct groups of people—those who accumulated wealth and those who did not—following the collapse of the Soviet Union. There is no easy way out of biopolitics here, but the logics of psychotherapeutic care also enable new ethical orientations, new modes of caring for self and others.

Foucauldian notions of both governmentality and self-cultivation have encouraged anthropologists and mental health practitioners alike: not only have they provided important conceptual frameworks within which anthropologists might contextualise and critique psychological realities, but they have also informed mental health practitioners’ own critical assessments of their professional worlds.

Psyches, minds, bodies, and brains

Within the historiographical context of the sciences, mental health emerged in mutual distinction and self-definition: physiology dealt with ‘the body’; psychology with ‘the mind’ or ‘psyche’. The so-called ‘sciences of the soul’ were particularly formative in defining a perceived human interiority through different practices of inspection and introspection (Coon 1993; Danziger 1998; Vidal 2011). The modern disciplines of the clinic thus helped divide the human into the mental and the physical, the psychological and the physiological. We have largely inherited this and other dichotomies from the eighteenth and nineteenth centuries where also ‘subjectivity’ and ‘objectivity’ emerged in contradistinction (Daston and Galison 2007). New psycho-technologies and scientific methods of introspection helped constitute ‘the human mind’ as an object of both scientific observation and intervention (Rieber 1980; Green 2010; Martin 2021). Reified as empirical objects, ‘the mind’ and ‘the body’ established in turn universalising ideals about ‘mental’ and ‘physical’ health, including their demarcation and distinct disciplinary subdivisions and specialisms.

With the rise of neuroscience in the twenty-first century, some feel that mental health has finally been anchored in the physical reality of the brain (Rose and Abi-Rached 2013). Consequently, a biologically orientated psychiatry now tends to see the distressed mind as a result of a biologically dysfunctional brain. Focusing on the persuasive power of brain images as experienced by people suffering from mental ill-health, Joseph Dumit’s (2003) ethnography shows how neuronal connectivities and chemistries, such as neurotransmitters, come to be seen as the aetiology of distress. Through encounters with neuroscientific causation models where brain images (such as PET scans) play a key role, people come to understand themselves as having chemical imbalances in their brain that cause mental illness such as depression. Neuroscientific facts cast the afflicted person as a dysfunctional brain by which they acquire a sense that they are their brain. The persuasive idea here is that ‘the mind is what the brain does’. But this understanding of mental health, in which the person experiences distress because of their brain, also comes to sit in tension with people’s sense of an agentive self and a capacity for self-determination: ‘is it me or my brain?’ (Dumit 2003).

Neurobiological theories that envisage the brain as a chemical laboratory of mental health have, for a long time now, equipped mental healthcare systems with scientific rationales for the use of psychopharmaceuticals in the treatment and management of people who experience distress (Petryna, Lakoff and Kleinman 2006; Jenkins 2010; Oldani 2014). Biomedical models of mental health can thus appear to locate responsibility and agency elsewhere, namely in the biochemical constitution of brains. Conversely, anthropologists have also described how psychotherapists have tended to locate moral responsibility on the part of the afflicted person (Kirsner 1998; J. Davies 2009). Littlewood (2002) has construed this tension as ‘naturalistic’ versus ‘personalistic’ explanations of mental ill-health. For the biomedically-trained psychiatrist, however, mental illness was no longer anyone’s fault: people were instead suffering from discrete ‘disorders’ that could be detected neurologically and treated with drugs (Luhrmann 2012). By the 1980s, neuro- and cognitive scientists were throwing out the psyche and Freud had become a footnote in psychology textbooks as psychoanalytic theories and methods were largely discredited. Psychological scientists have since strived hard to situate mental health research in the scientific principles and measures of ‘real science’ on an equal footing with biomedicine, contending that their discipline could otherwise be lost to ‘pseudoscience’ (cf. Lilienfeld, Lynn and Lohr 2004).

Notions of the biochemical and genetic brain remain instructive in contemporary understandings of mental ill-health and its treatments (Rose and Abi-Rached 2013). It is partly through the persuasive notion of a universal human physiology that the concept of mental health has acquired its own universality. But it has also brought with it a biological understanding of minds and maladies. For some anthropologists, this entails a problematic reductionism which has caused a ‘psychiatric drug epidemic’ by way of pathologising human distress (J. Davies 2017). Over the past forty years, numbers of mental disorders have grown exponentially in the publications of international diagnostic manuals, resulting in a proliferation of psychopathologies and market-driven pharmaceutical treatments (Petryna, Lakoff and Kleinman 2006). In an age of psychopharmacology, the ‘pharmaceutical self’ (Jenkins 2010) continues to shape experiences of mental health with vast social, ethical, and economic effects.

Anthropology encourages us to treat the division of health into the ‘mental’ and ‘physical’ as a matter of ethnographic interest. It is, in other words, worthy of study to anthropologists that some people conceptualise health in terms of ‘mind’ and ‘body’, and that these divisions in turn mark out different realities deemed ‘psychological’ and ‘physiological’. More recently, the ‘biopsychosocial’ model, invented by the American psychiatrist George L. Engel (1977), has been an attempt to bring together different disciplines (biology, psychology, social science) alongside their associated realities (body, mind, society). Rather than treating these as separate phenomena, this model claims to further a more holistic and scientifically rigorous understanding of humans as biopsychosocial beings. In the context of mental healthcare, such an understanding has in turn encouraged a perspective on treatment in which it is no longer sufficient for interventions to consider only biological or psychological factors. Instead, treatment must include ‘the social’ in the sense of environment, context, and culture (see e.g. Álvarez, Pagani and Meucci 2012; Gask 2018). According to this model, mental health is not only a case of a biological body (a case of ‘brain chemistry’, for instance) existing anterior to its psyche, social relations, or environment, but of a whole body-mind-subject—biologically, psychologically, and socially constituted—in a particular cultural world. However, the anthropologist might wonder at the separations and connections that are sought here. We might ask, for example, if the tripartite differentiation put forward in the ‘biopsychosocial’ is still suggestive of a problem rather than offering a novel reconciliation.

The proliferation of mental health

Following the Covid-19 outbreak in 2020, an upsurge in mental ill-health around the world and its associated medical, social, and economic impacts, including an exacerbation of existing health inequalities, have been widely reported on in scientific journals (e.g. Moreno et al. 2020; Wu et al. 2021). The Covid-19 pandemic has reinvigorated mental health as a matter of concern, from local and national levels of concern—pertaining to ‘individuals’ and ‘populations’—onto a cosmopolitan scale as part of ‘global mental health’ efforts. Mental health perceived as a global phenomenon, which might require equally global intervention, seems now a well-established reality that has received further experiential confirmation by reports of a worldwide mental health crisis of depression and anxiety disorders caused by the pandemic (e.g. Santomauro et al. 2021). Anthropological investigations of mental healthcare in times of ‘crisis’ seem therefore both pertinent and needed (see e.g. Wright 2022).

An important trajectory of anthropological research in the field of mental health has focused on the production of neuroscientific facts (Cohn 2008, 2010; Dumit 2004), the effects of pharmaceuticals (Dumit 2012; Jenkins 2010; Petryna, Lakoff and Kleinman 2006), and the construction of ‘disorders’, such as bipolar disorder (Martin 2007), autism, depression (Kitanaka 2012), and schizophrenia (Luhrmann and Marrow 2016). Furthermore, the expansion of ‘evidence-based psychological therapies’, especially cognitive behavioural therapy and mindfulness, and a proliferation of mental health initiatives and psy professions around the world have been a recent focus of ethnography by which new accountabilities, healing modalities, and configurations of care and politics have been examined (Brenman 2021; Bruun 2023; Cook and Cassaniti 2022; Duncan 2018; Huang 2018; Long 2018; Matza 2018; Pickersgill 2019b; Vogel 2017; Vorhölter 2021; Zhang 2020). These studies deal diversely with issues of precarity and access to mental healthcare, the transformation of therapeutic practices within and beyond their particular cultural or clinical environments, and the social and ethical consequences of particular scientific, economic, and political framings of mental health.

Another recent direction of research explores the digitalisation of mental health. The proliferation of digital monitoring technologies and AI-assisted interfaces—such as computerised therapeutics, online clinical platforms, smartphone apps, and wearable self-tracking devices—has constituted new fields of digitised mental healthcare (see e.g. Birk and Samuel 2020; Brandt and Stark 2018; Fullagar et al. 2017; Minozzo 2022; Pickersgill 2019a; Trnka 2022). Self-monitoring of ‘mental well-being’ is now part of many people’s daily health regimen as everyday activities of eating, sleeping, work, and recreation have become digitalised objects of observation shaped by ambitions to ‘encode wellness’ and promote personalised forms of health surveillance (Cearns forthcoming; Bruun forthcoming). This move towards ‘digital psy’ presents us with ‘disparate subjects, practices, places and temporalities of sensing, predicting, diagnosing, or treating mental health’ (Bemme, Brenman and Semel 2020). New therapeutic socialities and relationalities have unfolded.

Conclusion

The anthropology of mental health has come a long way. This entry has shown how ‘mental health’ can figure both as an analytical category in anthropology and an object of ethnography. Ethnographies of mental health can help us grasp not only the structural features of healthcare systems but also the modalities of healing and care in and beyond the clinic (e.g. Meyers 2013; Patton 2010), the medical and moral complexity of psychological distress (e.g. Luhrmann 2000; Zhang 2020), and the experiential realities that take shape around these issues. Where issues of authority and mental illness come together, anthropologists have demonstrated how people might resist, reinvent, or transform the therapeutic worlds in which they live (e.g. Brodwin 2013; Calabrese 2013; Myers 2015). Ethnography also teaches us that people’s experiences of mental health are situated in their own and others’ classifications and understandings of it (Bruun and Hutten forthcoming). Mental health thus entails particular kinds of theories that people have about themselves and others and the world in which they live. Anthropology can help us better understand why and how people experience mental distress but also what well-being and happiness might mean and look like.

Mental health might be seen to have acquired a hard-won universality. While some find this universality compelling and needed, others are critical of the ubiquity of mental health as an organising concept with the capacity to both normalise and pathologise. Kleinman, among others, contends that the expansion of the category of mental health ‘seems to simultaneously trivialize the most serious medical conditions and to medicalize social problems’ (2012, 118). He suggests that ‘fifty years from now this category will have been abandoned’ (Kleinman 2012, 118). Meanwhile, the realities of people’s experiences of mental health are unlikely to go away any time soon. In many parts of the world, mental health is now something that ‘everyone has’. To have mental health everywhere brings home its ethnographic salience.

Note

The writing of this article was supported by the European Research Council (ERC) under the European Union’s Horizon Programme for research and innovation (project no. 947867).

References

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Note on contributor

Mikkel Kenni Bruun is a Research Associate at King’s College London, where he currently works on the ERC SAMCOM project (https://samcom.uk). He also teaches anthropology at Cambridge University and is co-editing a volume on the anthropology of psychology. He holds a PhD in Social Anthropology from Pembroke College, Cambridge.

Dr Mikkel Kenni Bruun, Department of Digital Humanities, King’s College London, Strand, London WC2R 2LS, United Kingdom. kenni.bruun@kcl.ac.uk

[1] World Health Organization. 2022. “Mental disorders.” June 8. https://www.who.int/news-room/fact-sheets/detail/mental-disorders. Accessed 1 October 2022.

[2] World Health Organization. 2022. “Mental health.” June 17. https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response. Accessed 1 October 2022.

[3] World Health Organization. “Health and well-being.” https://www.who.int/data/gho/data/major-themes/health-and-well-being.

[4] Some early anthropological work that sought to study mental health explicitly is collected in the volume Culture and mental health, edited by Marvin Opler (1959). Many of its contributors were also professional psychiatrists.

[5] For a critique of cognitivist and cultural models in anthropology and psychology, see Toren 2012.

[6] A related issue concerns ‘structural competency’ efforts in the training of healthcare practitioners (Hansen and Metzl 2019). The ‘structural’ refers here to an analytical shift away from the level of the individual to examine institutional structures (clinical, educational, judicial, etc.) that underlie social determinants of health problems and access to care.

[7] It is important to note that Foucault was dealing mostly with the historiography of the ‘western’ subject. There are other histories and formations, of course. Recent anthropological writing on the relationship between the emergence of the psy sciences and colonialism has considered how we might think about presenting this history (Reyes-Foster 2018; see also Fanon 1963, on the ‘psycho-affective’ effects of colonisation). I am grateful to the anonymous reviewer for drawing my attention to this work.

[8] The DSM is currently in its fifth edition (DSM-5), published in 2013. It replaced the DSM-IV which appeared in 1994. For a critical review of the DSM-5, see Hacking (2013).

Editor:

Hanna Nieber

Resilience

Rebecca Tishler — Fri, 31 Mar 2023 17:20:11 +0000

Person during a 2009 flood in Vietnam. Photo: Rob

Kathrin Eitel

University of Zurich

Initially published 31 Mar 2023

http://doi.org/10.29164/23resilience

Abstract:

'Resilience’ is becoming a new policy buzzword. The term describes the ability to recover from expected and unexpected situations, stresses, or threats in order to sustain, thrive, and to move on. As a concept and as an approach, it guides people’s adaptation, persistence, and response strategies to sustainably cope with challenges of all kinds, such as pandemics, political oppression, or extreme weather events related to climate change. This entry highlights anthropological insights into and theoretical antecedents of resilience. Anthropologists have studied resilience in highly diverse contexts, ranging from cybernetics and systems theory, to the study of disaster, human psychology, science and technology studies, and multispecies research. The notion of resilience keeps being expanded and remains diverse. Theoretically, anthropologists have foregrounded the importance of viewing resilience as a practice and as being situated. They also emphasise the complexity of interactions and processes involved in coping with adversities and they often foreground a relational rather than an individualistic understanding of resilience. Importantly, resilience always includes more-than-human actors such as plants, animals, and technologies. How exactly people are able to become resilient is often determined by structural inequalities, (post-)colonisation and prevailing understandings of how the world ought to be. Anthropological research on resilience is much needed in times of adversity, as technological fixes to planetary threats are insufficient to ensure future wellbeing.

Introduction

Today, the term ‘resilience’ is on everyone's lips. As a policy strategy, it aims to ‘prepare’ communities, cities, regions, and even entire nations to cope with threats such as climate change, financial crises, or pandemics. As a new development buzzword, resilience has slowly replaced the long-cherished term of ‘sustainability’ that had taken over the world of politics and academia in previous decades. But what sorts of ideas are associated with resilience? How is the concept used and what have anthropologists found out when studying it? Looking at the literature, one learns that theories of resilience have been developed in very different research traditions, from ecology to psychology, economics, development studies, international relations, and climate policy. It is mostly through work in climate policy that resilience has become known beyond academic discourse since the 1990s (Wakefield, Grove and Chandler 2020). As a practical and situated feature of sociocultural life, resilience has also gained interest in anthropological research. That said, it has not replaced the adjacent concept of ‘adaptation’, which is an antecedent of resilience and has remained at the centre of much anthropological study. The genealogy presented in this entry blends together thoughts, concepts, and personal experiences related to resilience. It traces one path of the development of the concept, without, however, claiming that it is ‘the only’ path of its genesis.

At its most basic, resilience describes the ability to recover quickly from unexpected shocks and crises through, for example, adaptation, resistance, or robustness. One can think of it both as a process and an action, deriving partly from the Latin word resilire (re–salire) which means to recoil, to leap back.^{^[1]} Resilire, thus, describes the action of rebounding or swinging back to a stable status quo of existence. The underlying idea of responding to outside influence via ‘feedback’ harkens back to early cybernetics, a field of research that studied ‘control and communication’ of complex systems, be they biological, ecological, technological, or social (Wiener [1961] 2019). In the field of ecology, the concept of resilience developed prominently in the 1970s. The Canadian ecologist Crawford S. Holling (1973) hallmarked resilience as bound to environmental change. He emphasised the inherent capacities of ecological systems to absorb change, that is, to remain in their original state of functioning despite unexpected threats (Gunderson, Allen and Holling 2010). The concept of ‘social-ecological resilience’ then understands complex systems as adaptive, persistent, or transformable to their environment. That means that resilience includes adaptability, given that entities are expected to ‘bounce back’, as well as transformability, when they ‘bounce forward’ to create a ‘fundamentally new social-ecological system’ (Folke 2006, 262; Gibson-Graham et al. 2016).

Outside of academia, resilience is especially well known as a policy term that seeks to address the impacts of climate change globally. This is true for resilience programmes of the United Nations Human Settlement Programme, the World Bank, the Asian Development Bank, and of governments and development organisations around the world. Resilience as a policy tool and concept has been often criticised for being overly technocratic and ultimately detached from the socio-cultural specificities of peoples’ lives. That said, there have also been resilience interventions in the realm of disaster management and post-conflict settings that paint a less negative picture. Resilience-oriented policies have helped foster the integration of situated knowledge and complex situations into governance and have provided an opportunity to govern complexity locally (Chandler and Reid 2019; Chandler 2018; Chandler 2014a). An example of ‘best practice’ here is the policy endeavours of international organisations such as the Stockholm Environment Institute^{^[2]} that explicitly aim to integrate local knowledge into resilience strategies. The concept can thus make governance more responsive to people’s needs, as it foregrounds adaptation and learning from past interventions. It may even serve an ‘affirmative biopolitics of adaptation’ (Grove 2014, 198) that goes beyond programmes that only superficially help the vulnerable or that even perpetuate neoliberalism and social insecurity.

However, as ways of fostering resilience come often in the form of non-participatory policy interventions, technological fixes, and ‘authoritative examinations’ (Eriksen 2021), they risk being based on forms of knowledge and visions of the world that are tacitly imbued with deep-rooted power hierarchies and social inequalities. Resilience-oriented policies can thus have their roots in (post-)colonial thought and practice. They often enough maintain prevailing views from countries of the Global North, and they tend to postulate resilience as inherently positive (e.g. Ferguson [1994] 2009; Escobar 1995; Bollig 2014), thus risking perpetuating existing inequalities (e.g. Oliver-Smith 2017; Barrios 2016; Hastrup 2009a). This raises the question of who actually gets to participate in the definition, management, and governance of resilience. Given that even in governance theory and practice neither the concept nor its application are unified, the aim to foster communities’ capacity to deal with disaster risks often opposes divergent worldviews and ways to realise them (Schuller 2016; Barrios 2017a; Faas 2016).

For example, resilience-based policies presuppose knowledge of the nature of disasters and the likelihood of future shocks. They perpetuate claims of knowing how to ‘best’ to deal with disasters that are used to exercise power over communities, countries, and regions by framing them as insecure and unable to tackle adversities in their own ways (e.g. Evans and Reid 2014; Eitel 2022b). Given that resilience policies usually adhere to the Sustainable Development Goals, they often foster the well-known and long-entrenched hegemony of existing power systems. They seem to shift responsibilities to subjects ‘equally’, but in fact disregard their structural oppression and exploitation. Critiques of resilience policies—similar to those of ‘sustainability’— note that the regulation of the subject via resilience policies does not come only from the top down (from government to citizens), but that climate responsibilities are distributed in many different ways, for example along aid initiatives or global movements (e.g. Eitel 2022a). Resilience-based policies may also enable the production of a suffering ‘other’, putting responsibility on the shoulders of those who are not the main producers of climate disasters, for example (cf. Todd 2014).

While anthropological interest in resilience as a policy or an analytic concept is relatively recent, the discipline has long been concerned with the question of human adaptation as a driver of social change (e.g. Barth 1967; Ervin 2015). How societies adapt to their environment, and whether they are thereby capable of dealing with adversity, has been a focus of anthropological research for a long time. Social adaptation theories can thus be seen as the antecedent of today’s thinking around resilience. At the same time, adaptation is today understood as an essential feature of resilience.

In anthropology, resilience has developed through three research streams since the 1950s: first, cybernetics created the basis upon which complex systems, be they technical, ecological, social, or psychological, were understood. Cybernetics argued that it was important to think of a circular relationship between units and their ‘outer’ disturbances. Secondly, research on resilience has drawn from the interdisciplinary study of disasters, which scrutinises human responses to ‘catastrophic’ events, from research on psychological responses to shocks, and from Indigenous and local practices of resilience. Lastly, as anthropology begins to study the relations between humans and other species, it illustrates that we must pay greater attention to how human and non-human forms of agency intersect.

This history of anthropological research on resilience shows that we may need to widen our scope when it comes to studying the ‘subjects’ of resilience. Studies of urban resilience that focus on the strategies of entire cities to cope with climate shocks run side-by-side with research on multispecies resilience and studies of small-scale and rural communities. Simultaneously, the field of resilience remains interdisciplinary, drawing mainly on ecology (e.g. Folke 2016); human geography (e.g. Coaffee and Lee 2016; Keck and Sakdapolrak 2013; Sakakibara 2017); and international relations (e.g. Chandler 2014a; 2014b; Chandler and Reid 2019). Although the focus of this entry lies with the achievements of anthropological scholarship, these are frequently subject to interdisciplinary influence and contemporary discourse. Ethnographic research, which relies on participant observation, is particularly well placed to uncover situated knowledge and practices of resilience in different times and places. The situated nature of resilience is not just determined by social groups but also derives from specific social and historical contexts and an interplay of human and non-human actors (cf. Haraway 1988).

It is worth mentioning that the study of resilience is more than a theoretical exercise. It is part of ‘bringing about [a] transformative epoch via [anthropology’s] unique capacity to identify, track, describe, interpret, and communicate the human predicament’ (Crate 2011, 188). Studying resilience does not just show that different biologically-, socially-, and culturally-informed practices of adapting and responding to disturbances exist. It also tries to ensure that future social change occurs as a result of a reflective and decolonised way of collaborating across different lifeworlds. In doing so, it systematically takes power asymmetries and their roots into account.

Cybernetic studies of adaptation

Resilience as a concept was strongly influenced by cybernetic thinking, which views the world as a set of interlocking systems that are responsive, adaptive, and related to their environments. Cybernetics, which began to develop in the 1950s as a precursor of systems theory, saw itself as an interdisciplinary effort to capture the complexity of the world through a single ‘metalanguage’. Its goal was to create a universal canon of terms and concepts throughout all academic disciplines, aiming to support greater dialogue between them. Cybernetics thus studied technological, ecological, psychological and social systems by using the same terms. Realised as the research field of control and communication theory, cybernetics emphasised the importance of ‘feedback mechanisms’ (Wiener [1961] 2019, 18). Feedback ensures that any complex system maintains itself by adapting to its environment. ‘Systems’ were understood to comprise a diversity of ‘elements’, or components, which together enacted a functional unit that could either be ‘simple’ and predictable or ‘complex’ and thus self-organised and unpredictable. Systems were always held to stay in equilibrium, despite ’outer’ disturbances. What was astonishingly new and compelling about cybernetics were its attempts to understand such mechanisms of technological, environmental, psychological, and human organisation as non-linear and as being important beyond the individual.

Cybernetics included people from all disciplines, especially from physics, mathematics, biology, medicine, sociology, psychology, and economics as well as anthropologists such as Margaret Mead, Gregory Bateson, Clyde Kluckhohn, and Roy Rappaport. Cybernetically-informed anthropological theories of adaptation differed from older adaptation theories rooted in the social Darwinian notion of ‘survival of the fittest’, whose evolutionary conception declared societies successful—in the sense of survival—when they practised the best rational management of resources. Here, adaptation was often considered to be a form of advancement on an evolutionary ladder (e.g. Herzfeld 2006) and the development of cultural practices, such as subsistence activities and rituals, was interpreted as a response to the environment. Cybernetics, on the other hand, focuses on relations between culture and environment as self-regulating and self-maintaining complex systems. In this regard, cybernetics-informed anthropologists were more interested in the ways that systemic adaptation takes place, through acts of communication, under changing environmental conditions. They were less interested in evolutionary hierarchies or single adaptation processes.

Cybernetic thinking was criticised early on for failing to capture ‘social reality [which] could never be simulated in all its complexity’ (Rodin et al. 1978, 747) and for being too focused on adaptation and ‘elements’ rather than flesh and blood humans (Geertz [1963] 2000). Yet, many anthropologists were intrigued by the thought of social phenomena as systems, regulated by circular interactions. An awkward example from these times, which also exemplified cybernetics’ mathematical and mechanical underpinnings, was the example of a thermostat that regulates itself according to its surroundings. The term ‘system’ derives from Greek systēma, meaning a whole composed of several different members or parts (Liddell and Scott 1940). This fit quite well with the predominant understanding of cultures during the mid-twentieth century, which were deemed to be relatively isolated entities. Margaret Mead’s and Gregory Bateson’s cybernetics-related work had a tremendous influence on communication science, psychology, and subsequent research on psychological trauma (e.g., Wesley-Esquimax 2007, 2009; Kim et al. 2019). For example, Bateson showed how people suffering from schizophrenia were confronted by the dilemma of a double bind—a phenomenon in which people receive conflicting and paradoxical messages or signals and do not know how to respond to them.

During the sixties, a student of Bateson called Ray A. Rappaport was the first to conduct an encompassing field study of adaptation mechanisms among the Tsembaga Maring, an Indigenous subgroup of Maring-speakers living in the highlands of Papua New Guinea. Rappaport held that cultures were instrumental for the satisfaction of people’s needs, be it through religious, economic, or kinship practices. He therefore argued that Tsembaga rituals were not merely expressive, but helped regulate the group’s population and their relation to the environment (Rappaport 1968, 1971). His argument was backed by the fact that the Tsembaga engaged in the regular ritualistic slaughter of large parts of their pig populations to offer them to the spirits of their ancestors. Such pig sacrifice was associated with the absence of war and with overcoming illness and injury. It was also regulated by ecological factors such as the availability of pig fodder and the given number of pigs. Ecological factors, Rappaport argued, were thus driving ritual activity, which in turn governed peace, war, and human populations.

Consequently, cultures could be seen as systems that self-regulate and adapt to ecological stresses via long-term ritual cycles. In this way, rituals actively reduced the number of possibilities for the system (culture), by limiting the number of fights between different Maring-speaking groups, while ensuring the distribution of surplus pig meat (1971, 60; 1968). In this context, Rappaport defined adaptation as a process ‘by which organisms or groups of organisms, through responsive changes in their own states, structures, or compositions, maintain homeostasis in and among themselves’ (1971, 60). Adaptation took place through ‘enormously complex sets of interlocking feedback loops’ (Rappaport 1971, 75, footnote 9). Yet, ritualistic homeostasis (or balance) was absent in increasingly technological societies and feedback loops were eventually in need of being accurately recognised, monitored, or redirected in order to avoid maladaptation. This is not unusual, as a system is always embedded in its wider socio-ecological context, which can either promote or constrain effective coping (Torry 1979).

Rappaport’s work raised the question of how exactly adaptation to the environment became part and parcel of people’s culture (Steward 1972, 328). Julian Steward demonstrated that cultural change is not just dependent on adaptation practices that emerge, for example, through ritual activity, but also on knowledge and technologies that social groups acquire over time. Thus, Steward, who is also known as the founder of the field of ‘cultural ecology’, argued that arid climates and a need for irrigation tended to lead to increased social stratification and, eventually to the development of the state. Environmental adaptation, according to Steward, ultimately resulted in stable ‘core features’ of different cultures. What Rappaport and Stewart share with much early anthropological work on adaptation is the argument that humans adapted to ecological adversities in highly complex and recursive ways, ultimately to ensure the survival of the community as a whole. Second, cybernetically-informed theories of adaptation focused on how people maintain or reverse states of equilibrium that give different cultures their unique ‘core’ characteristics.

Eventually, the early cybernetics-informed adaptation studies were mainly criticised for assuming a stable state of equilibrium to which complex systems automatically bounce back after environmental disturbances. Holling (1973), for example, pointed out that socio-ecological stability is rather dynamic as it maintains the different properties of systems that enable survival. These properties, including stability, variability, persistence, or resistance, may change in different ways and times to maintain other properties. One such property that is of special interest is resilience, a ‘measure of persistence’ and the ‘ability to absorb change and disturbance’ (Holling 1973, 14). Interestingly, resilience can be very high because of the instability of an overall system. For example, the budworm, i.e. a common pest on all kinds of crops, was so persistent in Canada because its population was able to dissolve into smaller parts during disturbances, before re-building in even more adaptive ways than previously. Contrary to Rappaport, who saw homeostatic stability as a desired aim of adaptation after disturbances, Holling understood stability and resilience as distinct from each other and adaptation as one part of resilience. Anthropological insights that communities tend to change dynamically over time further contradicted the assumption of a prior state of stability to which communities are thought to leap back after an environmental shock. The obvious pitfall in considering the ‘adaptive capacities’ of communities is thus to assume from the start that their change serves a certain purpose.

Cybernetics scholarship was also criticised for perceiving cultures as systems that automatically remove marginalised groups from history. Indeed, analysts themselves may contribute to such processes as ‘the actual consequences of their own politics of representation’ (Blaser 2009, 881). Cybernetics often seemed one-dimensional and apolitical because it represented the interests of only one, usually dominant, group and did not take cultural diversity sufficiently into account (e.g. Mandler 2009; Fabian [1983] 2002). Its endeavour to work with a metalanguage and the idea of ‘mechanisms’ that could be found everywhere eventually failed as its findings were hard to generalise. Comparing the organisation and communication of ants with that of Indigenous communities or mechanical-electrical system, for example, meant radically reducing the complexity of humans, non-human life forms, and objects under study. Mathematical models that were frequently used to measure and analyse situations could neither sufficiently illustrate nor anticipate how environmental and social processes interacted (Vayda and McCay 1975).

On the upside, cybernetics was one of the first truly interdisciplinary research fields, pre-figuring contemporary game theory, new materialism, systems theory, and much psychological and cognitive work (e.g., Maturana and Varela 1987). However, its failures may be why cybernetically-informed anthropological studies have been largely neglected, even though they contributed significantly to the further development of environmental and ecological anthropology (Hagner, Hörl and Pias 2008). Its approaches to adaptation and resilience assumed a relatively stark dichotomy between systems and their environment, as was common in much of the twentieth century, and one of its main controversies lay in whether nature or culture determined socio-cultural behaviour. As anthropologists learned that cultures were less and less ‘closed entities’ (if ever they had been), they shifted their focus from the question of ‘how’ adaptation works in a scheme of sequential cultural development toward the question of ‘to/for what’ and ‘for whom’ it works. Such questions were investigated in great depth in the interdisciplinary research field of disaster studies that began to develop in particular during the 1970s.

Resilience and disaster studies

Contemporary work on resilience is greatly inspired by the interdisciplinary research on disasters. Here disasters, risks, and catastrophes tend to be understood as part of larger social and historical processes that reveal certain groups to be more vulnerable than others (e.g. Faas 2016). The anthropologist Roberto E. Barrios, for example, defines catastrophes as

the end result of historical processes by which human practices enhance the materially destructive and socially disruptive capacities of geophysical phenomena, technological malfunctions, and communicable diseases and inequitably distribute disaster risk according to lines of gender, race, class, and ethnicity (2017b, 151).

In this sense, disasters are not isolated events but socio-material phenomena that result from larger and longer processes such as the Industrial Revolution, the rise of capitalism, neoliberalism, or (post-)colonialism (e.g. Barrios 2016; Oliver-Smith 2016, 2017; Schuller and Button 2020; Hsu, Howitt and Miller 2015). Anthropological research on disaster response thus focuses on how vulnerability is produced in the first place, and how this vulnerability interacts with disaster risk reduction, response, recovery, and relief (Oliver-Smith and Hoffman [1999] 2020; Hoffman 2017). It has shown that top-down resilience measures can reify a moral canon that defines what and who is worthy to be considered to survive in the Anthropocene. During post-earthquake reconstruction in Haiti, for instance, the NGO-run humanitarian aid system was based on a (post-)colonial politics of vulnerability that portrays people and entire nations as victims in order to legitimise a ‘lack of resilience’ that requires action (Schuller 2016, see also Evans and Reid 2014).

Resilience and vulnerability thus often work together, as vulnerability refers to ‘the characteristics of a person or group and their situation that influence their capacity to anticipate, cope with, resist and recover from the impact of a natural hazard’ (Wisner et al. 2004, 11). When China's Sichuan province was hit by a devastating earthquake in 2008, for example, government recovery plans for the Qiang Indigenous community helped perpetuate their political subordination, turning people into ‘passive gift recipients’ (Zhang 2016, 92). The management of disasters by government agencies and recovery experts can thus reinforce vulnerabilities and even create new ones. Moreover, as US government neglect in the recovery of New Orleans from Hurricane Katrina has shown, communities also need to adapt emotionally to catastrophes and recovery programmes. Feelings are critical to people's experiences of both disaster and recovery, but are all too often left out of planned recovery and post-disaster programs (Barrios 2015, 4), which thereby, again, risks increasing vulnerability.

Neoliberalism plays an important role in co-constructing vulnerability through disaster management. Environmental managers and government actors in a climate vulnerable coastal area in Maryland, for example, considered inhabitants of the Deal Island Peninsula communities to be ‘liabilities’ rather than people maintaining livelihoods in their historic homeland (Johnson et al. 2017; Johnson 2016). As a result of ‘disaster capitalism’, in which environmental crises are used to serve the interests of capital (Faas 2018, 32; Klein 2007), these ‘liabilities’ are subject to programmes that promote entrepreneurship as successful disaster response (Faas 2018). The production of capitalist subjects in the form of entrepreneurs, or ‘petit capitalists’, exposes the limits of much contemporary institutional thinking, which remains unable to go beyond neoliberal disaster response. Capitalist subjects are here produced along with disaster capitalism through an initiation into business management that is intended to contribute to regional recovery. Ultimately, dominant interests provoke visions of the future and ambitions that appear to be local but are imbued with the goals of the neoliberal state. Resilience policies can thus reinforce and perpetuate the vulnerability of groups whilst simultaneously maintaining the very same capitalist dynamics that are responsible for anthropogenic climate change and socio-ecological disasters (cf. Wakefield, Grove and Chandler 2020)

Studying the concrete impacts that resilience policies have on particular sites draws attention to the questions: ‘When is resilience achieved for whom?’ and ‘To what extent is it achieved?’ Ethnographic studies have answered these questions by providing insights into lived experiences, strategies, and narratives that circulate ‘on the ground’ and are used, changed, and adapted in relation to environmental changes that require a response (Davidson-Hunt and Berkes 2006, 69; Ingold 2011). Analysing local responses offers fruitful and complementary perspectives to prevailing normative and development-informed visions of resilience (e.g., Rival 2009; Hastrup 2009b; Vium 2009). In the Pacific, for example, people’s political resistance has been shown to be a form of resilience as well as a way of contesting state-led resilience strategies (Dousset and Nayral 2019). Ethnographic research in two East African communities has further identified response diversity as a key driver of resilience. The Ngisonyoka, nomadic herders in Africa’s Great Rift Valley, for example, respond to social and environmental threats through a variety of mechanisms, including group mobility, livestock diversification, and the creation of broad social networks. This variety of activities drives response efficacy, allows social groups to persist, and enables them to limit their impact on the environment (Leslie and McCabe 2013, 128). Lived resilience thus seems to require respect for a variety of practices and voices of people living in climate-prone areas (Barrios 2016).

Resilience, therefore, is not static but is rather a result of social learning from previous crises that may become integral to patterns of cultural knowledge. Coping with an individual hazard or disaster, on the other hand, implies short-term decisions in (relatively) new situations. These may or may not be adopted into a cultural canon and manifested in long-term adaptation strategies (Smith 2017; Bennett 1995). Adapting to something or somebody is tangible both in daily practice and in the space in which it is embedded, for example when regions face severe droughts and dwellers alter their practices of wayfinding through these changed landscapes (Vium 2009). Adapting for something or somebody can imply a mode of care for another future, and care for individual or collective well-being today. Let us now turn toward the small field of anthropological research on psychological resilience.

Psychological resilience

How people cope with disasters and crises at a psychological level is a subject of study in interdisciplinary research on psychological resilience, often with roots in Gregory Bateson’s ideas of the mind ([1972] 2000; [1979] 2002), and in development psychology (e.g., Garmezy 1971, 1991). Psychologists deal with resilience as a personal defence mechanism that can be strengthened and enhanced. The relatively small field of the anthropology of psychological resilience evolved^{^[3]}, concentrating on people’s individual life trajectories and on the way communities cultivate resilience as a means to respond more or less successfully to adversities (Wexler 2014, Wexler et al. 2014; Zraly et al. 2011; Obrist and Büchi 2008). These studies often include a focus on political and economic forces of oppression and violence (e.g. Cox 2015; Eggerman and Panter-Brick 2010; Zraly and Nyirazinyoye 2010).

Anthropological scholarship has unveiled, moreover, the insight that resilience in daily life is often reliant upon broader collective memories and histories (e.g. Ungar 2008; Foxen 2010; Lewis 2013, 2018, 2019; Kirmayer et al. 2011; Mullings and Wali 2001). For example, comparative work on trauma diagnosis and treatment among survivors of the 2006 July War in Lebanon and that of Syrian refugees post-2011 shows that suffering is more than just an internalised psychic condition. Instead, suffering can be understood as a constantly shifting subject position in a social context like Lebanon, where violence and aid economies continuously change its nature. Here, the local concept sumud, which can be translated as psycho-political steadfastness, patience, and resistance, reflects the social contingency of suffering and resilience, as sumud is subject to constant politically-inflected re-interpretation. Indeed, sumud can be interpreted as both a form of psychological resilience and ‘a postcolonial tool of resistance, a political movement and an everyday embodied practice’ (Moghnieh 2021, 6). In Afghanistan, resilience is also collectively enacted, and in this case bound to values of living an honourable life. Cultural values such as kinship and family honour are essential to maintain ‘a sense of order, hope, and meaning to life’ (Panter-Brick 2014, 442; Eggerman and Panter-Brick 2010). Anthropological studies have thus shown that resilience, tied to wellbeing and health, is undergirded by processes that are far-reaching, harking back to long-gone periods of oppression, such as colonialism, whilst also taking current power structures into account.

In this way, resilience can even be grounded in toxic entanglements between people and chronic economic and political instability. Residents of Mexico City’s working class neighbourhood Colonia Periférico, for example, have been shown to be particularly resilient and maintain power as they decide what ‘outer’ disturbance gets ‘inside’ the body and the mind (Roberts 2017). They may decide to consume sugary and highly processed sodas, some of them traffic drugs and consume marijuana and a glue solvent called activo, and all of them live with the stench of the neighbourhood’s air pollution. Health workers consider the local consumption of toxic substances to signal the absence of resilience. To them, resilience is grounded in the impermeability of the body. Yet, Elizabeth Roberts (2017) provides an alternative interpretation, showing that people's toxic entanglements with their environment provides them with moments of social pleasure and care whilst keeping health workers and the police at bay. The neighbourhood’s reliance on toxic consumption may thus be the source of its resilience.

The link between trauma and resilience has been of particular interest to anthropologists. The study of people in post-apartheid Cape Town and in Brazilian favelas has shown that people are capable of much higher degrees of resilience than citizens of the affluent parts of the Global North may imagine (Scheper-Hughes 2008). People are capable of resisting even chronic ‘states of emergency’ and the resulting traumas through survival strategies that include developing values such as strength, toughness, asceticism, stoicism, and even the postponement of motherly love until children are likely to survive (Scheper-Hughes 2008, 25). Our psychological response to too much death and loss may be that of ‘patient resignation’, subduing both outrage and deep sorrow over human tragedy. In this way, human frailty is compounded by a ‘possibly even bio-evolutionarily derived, certainly historically situated, and culturally elaborated capacity for resilience’ (Scheper-Hughes 2008, 52). It seems that those who suffer from post-traumatic stress disorder and who live through constant crises and terror may normalise suffering as part of building resilience (Scheper-Hughes 2008, 52).

Laying a cornerstone for an understanding of resilience as a feature of daily life based on cultural values and long histories of suffering, many ethnographic studies shifted the attention toward structural inequalities that determine who ‘is required to survive and even thrive’ (Scheper-Hughes 2008, 37) in times of catastrophic events. The idea that resilience is manifold is also demonstrated by a recent study of cancer patients in Soweto, South Africa. The study focuses on ‘idioms of resilience’, understood as the ‘means of experiencing and expressing positive adaptation and well-being in the midst of adversity’ (Kim et al. 2019, 1). It reveals that idioms of resilience in crisis-ridden Soweto may result in different forms of acceptance (or ukwamukela in isiZulu). Such acceptance allows people to shift their attention away from their own problems to focus on family, neighbours, and religious life (Kim et al. 2019).

In many of the examples above, resilience is more than a result of historical contingencies. It needs to be understood as a capacity to continue life (Wesley-Esquimaux 2007, 2009). In studying First Nations people in the Americas, the First Nation woman Cynthia Wesley-Equimaux notes that colonisation, discrimination, and marginalisation resulted in the ‘intergenerational transmission of historic trauma’ (Wesley-Esquimaux and Smolewski 2004, iii). These traumatic recollections entered people’s collective memory and were enacted through cultural symbols, rituals, and habits, for example through stories about terror. Eventually, the traumatic experiences became culturally embedded, resulting in repressed feelings of emptiness, depression, and numbness, which in turn led to a gradual dissolution of people’s collective identity. First Nation women in particular struggle with these negative, intergenerational experiences as they still strive to do good for their families and communities.

Local knowledge that reflects social realities and historical contingencies provide a more positive angle of viewing resilience as empowerment. Rather than resilience, Wesley-Equimaux (2009, 26) calls for an emphasis on resiliency, meaning to ‘rebound from challenges one encounters in daily life’. Resiliency refers here to a form of flexibility that enables the reframing of trauma and life narratives by situating them in sociocultural contexts so as to make them ‘re-readable’. Emphasising the positive forces of the term, resiliency avoids seeing people only as ‘suffering subjects’ and as related to deficits but rather as potentially empowering. This approach chimes with what the Māori scholar Mason Durie (2006, 8) claims to be a form of ‘Indigenous resilience’, that is, ‘a reflection of an innate determination by Indigenous peoples to succeed’. His take on resilience provides a viewpoint that does not depict Indigenous people as suffering ‘others’ or negating their historic disadvantages, but that ‘allows the Indigenous challenge to be reconfigured as a search for success rather than an explanation of failure’ (2006, 8). Here and in Wesley-Equimaux’s example, resilience and resiliency have positive connotations, focusing on success, strengths, and empowerment that enable social transformations toward healthier and better futures.

In sum, anthropological research has shown that the ordinariness of suffering cannot be adequately understood without taking into account associated cognitive processes, collective experiences, and traumatic embodiments (cf. Kim et al. 2019). Studying resilience can foreground suffering, but it may also illustrate how humans create ‘well-being rather than survival, salutogenesis rather than pathology, and the promotion of human dignity rather than mere alleviation of human misery’ (Panter-Brick 2014, 438). Because psychological resilience is a necessary precondition for groups to cope well with disturbances, stresses, and violent contingencies such as trauma, it fruitfully ties in with other forms of resilience research (cf. Bollig 2014). However, looking at human responses and adaptation processes is only one way to understand how people and communities respond to threats. A more removed anthropological approach to resilience, which sees communities neither moving ‘back’ nor ‘forward’ to a state of stability, focuses on how prevailing normative notions of resilience themselves are brought about and circulate (e.g. Rose and Lentzos 2017).

More-than-human resilience

The divide between nature and culture played a crucial role in the development of early anthropological theories of adaptation. Cybernetic thinking about enclosed elements and systems that were held to be distinct from their outer environments frequently opposed cultures to outside nature. Yet, recent scholarship has demonstrated that the environment is also produced, shaped, and enacted by culture (e.g., Scoones 1999; Ingold 1990; Escobar 1999). Culture and the environment always reproduce each other, for example when biotechnology enables the creation of ‘new’ versions of nature that in turn impact sociocultural processes (Scoones 1999). Given that authors such as Bruno Latour (1993) and Donna J. Haraway (1987) have established that nature and culture are always intertwined as ‘naturecultures’, anthropology has had to rethink the notion of resilience by asking for whom nature exists (Haraway 1987) and through which worldviews it is enacted (Blaser 2013; Jensen 2015).

By focusing on the production of knowledge and technology, the interdisciplinary research field of science and technology studies (STS) questions, for example, how knowledge about flood resilience results from the interplay of many kinds of human and non-human actors, such as mangroves and satellite images. This connectedness of actors across boundaries of nature and culture means that multispecies studies of resilience have become more important. Ethnographic research now focuses on humans as much as animals, plants, and technologies and their interferences with each other to understand how resilience is enacted (e.g., Chao 2022; Willerslev 2009). The indigenous Yanyuwa of Northern Australia, for example, remain resilient in the face of postcolonial and other forms of violence by building a myriad of relationships. They ‘keep company’ with the land, with non-human species, and with their ancestors to deal with adversity (Kearney 2022). They create resilience by practising ‘a multidimensional art of relating’, despite postcolonial and on-going violence. The Iñupiat of Arctic Alaska are also able to survive in a difficult environment marked by climate change through resiliency that is grounded in deep knowledge about entities and species on land, in water, and in the sky (Sakakibara 2020). They have developed an intimate, spiritual, and intense relationship with bowhead whales, mythical creatures that have a decisive impact on their social lives. Storytelling, dancing, drumming, and political engagement linked to the whales all help the Iñupiat foster notions of reciprocity and respect and respond to climate change in a constructive manner (see also Herman 2016).

Focusing on ontologies is particularly fruitful when studying resilience, whether these are culturally specific and relational, as in the Yanyuwa and the Iñupiat examples above, or more practical in nature (Gad, Jensen and Winthereik 2015; Jensen 2021). The practical ontologies of floods, for instance, uncovers different worldviews by different actors at stake in flood protection: policy actors may perceive flood protection as an opportunity to form urban space and implement technological mega-projects; fish may identify it as a danger given that submerging the sediment that causes floods reduces their living space; while dwellers of the affected region may consider it as a mundane situation, and nothing to get stressed about.

STS-inspired anthropological scholarship has illuminated that technologies based on a ‘modern’ ontology marked by a belief in progress and the human domination of nature play a significant role in how resilience is imagined and implemented. This ontology lies at the heart of technological fixes as the single solution to combat climate change. In south-west Bangladesh, for example, climate-smart houses are meant to protect inhabitants against cyclones and flooding while supporting an efficient use of water and energy (Cons 2018). While such techno-fixes turn out to be inherently exclusionary for most of the population, they tend to gain praise in policy circles around the world. In this instance, resilience policies produce new patterns of exploitation and expropriation by holding locals in climate-insecure places (Cons 2021).

Conceiving of resilience as a more-than-human endeavour, and paying close attention to spatially and temporally wide-ranging relationships, enables researchers to see the concept in a new light, without thereby losing sight of important existing inequalities and discriminations along the lines of class and ethnic groups. At the same time, anthropological scholarship demonstrates ‘alternative’ ways of dealing with crises that are either based on long-established relationships to the environment, histories of oppression and suffering, or on approved methods for coping with crises. The question of whether a community ‘possesses’ or ‘obtains the capacity’ for resilience often gives way to deciphering multiple existing modes of resiliency. Given that the impacts of climate change, even if not locally caused, are unfolding locally, more-than-human resilience must be also considered in relation to land, heritage, and experiences of oppression and discrimination.

Conclusion

Contemporary resilience research is rooted in the fields of cybernetics, disaster studies, and psychology as well as in STS and multispecies research. Anthropologists understand resilience primarily relationally as a practice and as historically and culturally situated. Much ethnographic work on resilience shows that it is dynamic in character and multiple in form, as well as being shaped by constantly shifting socio-material circumstances and multiple power constellations.

Studies of resilience based on anthropological research have provided significant insights for understanding socio-ecological phenomena and human-environment relationships. They show that people’s everyday coping practices can transform into adaptive strategies developed in relation to highly specific environmental situations. They also foreground the diversity of thoughts, worldviews, rituals, relations, and practical skills required by communities to deal with hazards, creeping environmental change, and psychological disasters. Ethnographic studies of lived resilience tend to challenge prevailing notions of how to deal with adversities by including alternative, situated definitions to the vocabulary of anthropogenic disaster. Examining lived resilience should be as much the focus of future study as examining prevailing knowledge formations that emerge through resilience policies or prevention and recovery programs.

Anthropology’s critical stance vis-à-vis state- and market-friendly resilience policies and programs stems from the insight that local resilience practices emerge as much in reaction to shocks and ‘slow disasters’, as they do in response to political and socioeconomic interventions along hegemonic and postcolonial lines. Everyday resilience reveals systematic subjugation and discrimination, for example through disaster aid programs that perpetuate vulnerability. It points to imposed politics of vulnerability, disaster capitalism, and invisible violence that run along demarcation lines of race, gender, class, and ethnicity. In this way, everyday resilience frequently includes and creates more-than-human lifeworlds that span across multiple timeframes, spaces, and sociocultural areas.

One question for future research may then be not what resilience is, but when and how it is socioculturally produced. To what does it refer—as a way of dealing with historical legacies, current adversities, and future uncertainties–and for what is it used? Is resilience built to deal with unexpected shocks (e.g., earthquakes), expected situations (e.g., droughts or floods), or also potential futures (e.g., hurricanes or pandemics)? Is resilience capable of coping with perfectly unexpected disasters that might ‘break in’? These are questions that need to be further explored, accompanied by an interest in practices of care and relationality that benefit not only human beings but also their companion species and wider environments. Anthropology shows that resilience is not inherently grounded in deficits and suffering but that it also illustrates an astounding degree of agency and creativity that humans and nonhumans who strive to remain resilient display in the process. As such, the study of resilience has the potential to unpack multiple forms of responses to adversity. Something we can all learn from.

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Note on contributor

Kathrin Eitel is a cultural anthropologist and feminist STS scholar whose ethnographic research is pivoting around environmental disasters such as the exuberant occurrence of synthetic waste in urban Cambodia and the recurrences of floods in lower Vietnam. She is interested in situated resilience practices and the impact of worldviews that circulate along deeply rooted infrastructures of power, materialising in development policies and technological fixes. Eitel is the author of Recycling infrastructures in Cambodia: Circularity, waste, and urban life in Phnom Penh (2022, Routledge).

Kathrin Eitel, Department of Social Anthropology and Cultural Studies, University of Zurich, Switzerland. Email: kathrin.eitel@posteo.de, Website: www.kathrineitel.com, ORCID: 0000-0001-8200-9495.

[1] Oxford English Dictionary. 2022. “resilience, n.”. https://www.oed.com/view/Entry/163619?redirectedFrom=resilience.

^{^[2]} Stockholm Environment Institute. “About.” https://www.sei.org/about-sei/

^{^[3]} For an extensive overview, see Panter-Brick (2014).

Mind

Rebecca Tishler — Sat, 02 Oct 2021 17:37:15 +0000

Tanya Marie Luhrmann

Stanford University

Initially published 2 Oct 2021

http://doi.org/10.29164/21mind

Abstract:

There is something phenomenologically basic about the human experience of awareness, or consciousness. All ethnographies describe people who think, feel, imagine, hope, and are aware. Yet anthropologists have shown that different social worlds understand mental life (we will call this ‘mind’) in different ways. Different cultures imagine mental life differently, both in what thought can do, and how one might draw the boundary between mind and world. These culturally different understandings have real social consequences. They affect the way that people imagine what it is to be a self, the way they understand time and history, the way they understand spirits and rituals, the way they experience illness and health. More recently, anthropologists have begun to use the phrase ‘anthropology of mind’ to describe the comparative exploration of specific dimensions in the way the mind-world boundary is imagined. For example, they have observed that in some social worlds, one finds mental ‘opacity’. In those social worlds, people understand that one cannot know—or, should not presume to know—what someone else is thinking or intending. Another dimension is ‘porosity’. In some social worlds, the mind-world boundary is imagined to be permeable, so that thoughts pass into the world directly, and are potent. Someone can feel vulnerable because a witch, for example, thinks envious thoughts—and those thoughts are understood to be powerful enough to enter someone else’s body and harm it. They have different views about who or what has a mind. It turns out that the way we think about the mind in the West is culturally peculiar.

Introduction

The basic question of an anthropological approach to mind is whether there are culturally different representations of mental life, broadly construed, and if so, whether and how they matter. (There is another, related question, which is whether people in different social worlds have different cognitive orientations; that is a more psychological question and will not be discussed in detail here.) The question starts with the presumption that the experience of conscious awareness—thinking, feeling, reflecting, knowing, hoping, desiring and so forth—is phenomenologically basic for humans, but that different social worlds often represent this domain of experience differently. Some social worlds sharply distinguish mind from body; others do not. Some treat thoughts as potent, so that one person’s angry private thought can hurt another person’s body directly; others do not. Some treat the mind as the source of identity, so that what someone thinks defines who they are; others do not. Some believe that personal feelings should be shared widely and easily; others do not. For some, the mind is an epiphenomenon of the brain, and it is the brain that is more real; for others, the mind is part of a spiritual reality more real than the everyday world. The anthropological approach to mind sets out to understand what we can know about these cultural differences in the representation of mind, and how those differences affect those who hold them.

Conceptions of the mind in early ethnographies

The observation that different social worlds imagine mental life differently was one of the great achievements of early anthropology and the source of some of its most interesting debates, although these observations were not always made systematically or explicitly. The first point to be made was that different representations of mental life did exist. One of the most important essays here was by a Frenchman, Marcel Mauss. His 1938 essay, ‘A category of the human mind: the notion of person; the notion of self’ argued that across time and space, everywhere, something like a self is present, but it is not always expressed by the concepts ‘me’ or ‘I’, (‘moi’ or ‘je’). Everywhere, that is, humans are aware of themselves as individual beings: as Mauss writes, ‘There has never existed a human being who has not been aware, not only of his body, but also at the same time of his individuality, both spiritual and physical’ (1985 [1938]: 3). At the same time, they were not always aware of being aware. All humans, Mauss argued, had a sense of the moi, a sense of ‘me-ness’, but in different societies, with different systems of law, religion, customs, social structure, and mentality, they conceive of this moi in different ways. Among the Zuni, the Pueblo Indians in North America studied by Frank Cushing and Matilda Coxe Stevenson at the end of the nineteenth century, a person is first and foremost someone who occupies a role within the clan (Cushing 1896). A Zuni person’s sense of individual uniqueness receded against their sense of prescribed status, the way an athlete in a team sport can find that their sense of self feels so much less important than who they are on their team. One is first and foremost a ‘personage’, as Mauss put it: a name, a title, a placeholder for those who will come later. Among the Kwakiutl, another indigenous group in North America, studied in the early twentieth century by Franz Boas among others, every stage of life was named and designated, with many represented by masks used in sacred rituals (Boas 1921). Among communities like the Zuni and the Kwakiutl, people are imagined primarily through their definite location in the social whole—mother, child, ancestor, and so forth, cycling through their roles like leaves on a forest floor. Mauss argued that the idea that a person’s private, personal thoughts and feelings make them who they are is really quite recent. In fact, he claimed that even in the West, the psychological self—the person defined by personal thoughts and feelings—did not become of paramount importance until the nineteenth century.

Another French anthropologist, Maurice Leenhardt, provided an extended ethnographic example of a non-Western representation of inner mental life. Leenhardt had spent two decades among the Houailou speakers (he calls them the Canaque) who lived in the western Pacific archipelago known in English as New Caledonia, first as a missionary and then as an anthropologist, at the beginning of the twentieth century. In his classic ethnography, Do Kamo, Leenhard argued that the Canaque avoid the kind of analytic categories that came easily to his French readership. For them, ‘thought springs from viscera’ (1979 [1947]: 7). What he seemed to mean by this was that they did not have many abstract words. Before the missionaries came, he wrote, the Canaque did not use words to refer to thought or to thinking. They didn’t really have a term for the body either, nor did they talk as if anything happened ‘inside’ the body. ‘Man and world, the living and the dead, gods and totems, each plays its own role, but each lacks distinct boundaries’, Leenhard explained (1979 [1947]: 74). People have some sense of these distinctions, but their distinctness is not culturally meaningful. The Canaque did not have a sense that, for example, that time passes in a way that is the same for all. Nor did they clearly seem to separate myth from the empirical everyday. Leenhardt wrote that instead, the Canaque lived in ‘a reality where the mythic forms of life are visible to the eye, and where [Canaque] verbal expressions have a mythic tone in which myth can be perceived as an experienced reality’ (1979 [1947]: 19). Leenhardt told a now-famous story: that after decades of talking to the Canaque about Christianity, he asked them if he and his wife had brought the spirit to their way of thinking. No, they replied, we have always had the spirit: ‘What you have brought us is the body’ (1979: 164).

Yet another extended ethnographic example came from Godfrey Lienhardt’s Divinity and experience (1961). That book set out to understand the religion of the Dinka of Southern Sudan, with whom Lienhardt had lived for around three years in the late 1940s. The Dinka are a pastoralist people who move between permanent and wet-season settlements as the Nile river valley swells with rain. Lienhardt was fascinated by what he calls ‘symbolic action’: that, for example, a man hurrying home later than he wished might tie a tuft of grass to delay the meal at the journey’s end. Lienhardt’s ethnographic goal was to explain that this is not a magical act: ‘No Dinka thinks that by performing such an action he has actually assured the result he hopes for’ (1961: 283). The symbolic action, he wrote, is not a substitute for practical action, but a preparation for it. The person tying the knot makes an external representation of a mental intention: a model, as the author put it, of their hopes and desires. Symbolic actions do not change historical events. They change the way we prepare for and react to them.

All well and good: this sounds like something secular Western readers might say. But Lienhardt also laid out a local understanding of mind that, he argued, would have made symbolic action feel more real. He held that the Dinka had no conception of a domain of thought and feeling inside of them which symbolic action might effect: ‘The Dinka have no conception which at all closely corresponds to our popular modern conception of the “mind” as mediating and, as it were, storing up experiences of the self’ (1961: 149). Dinka culture did not model the mind as separate from the world. Lienhardt writes:

So it seems that what we should call in some cases the ‘memories’ of experiences, and regard therefore as in some way intrinsic and interior to the remembering person and modified in their effect upon him by that interiority, appear to the Dinka as exteriorly acting upon him (1961: 149).

You could not say to a Dinka person that a dream was ‘only’ a dream, or that an experience was ‘only’ psychological. ‘They do not make the kind of distinction between the psyche and the world which would make such interpretations significant for them’ (1961: 149). For those who hold such representations, symbolic action is more powerful. The doer of the action has fewer resources with which he can dismiss its efficacy as only a thought in the mind or only a dream.

Early anthropologists did not just show that representations of mental life were more or less abstract. They also argued that people in different social worlds thought differently about mental causation. One of the more forceful arguments was made by another French philosopher-anthropologist, Lucian Lévy-Bruhl. In How natives think (1979 [1926]), he argued that people who were not literate, and who lived in small scale, traditional societies (he called them ‘primitive’) imagined thought as potent in its own right. Such people imagined themselves as participating in the external world, and the external world as participating in their minds and bodies. A man might believe, for example, that his enemies would have power over him if they simply knew his name; he might believe that his dream was a visitation by a real and external spirit. Lévy-Bruhl called such an orientation ‘mystical’ and he described it as governed by ‘the law of participation’ in which objects are ‘both themselves and other than themselves’ (1979 [1926]: 76). He also called it ‘prelogical’. In the modern West, he thought, people define reality as independent of what they think and feel: ‘Our perception is directed toward the apprehension of an objective reality, and this reality alone’ (1979 [1926]: 59). Non-modern people, he argued, imagined their thinking as more entangled in the world. At this point, Lévy-Bruhl was more focused on what he took to be the mistaken thinking of the pre-modern world, and confused ideas about what was real, than on a different representation of the mind. These days, readers might find his evolutionist language to be dated and inappropriate. The question he raised—whether non-literate people in small societies might think about thought differently—is still important.

At the end of his life, in the posthumous Notebooks, Lévy-Bruhl abandoned the claim that so-called primitive people thought differently than modern Westerners do. (He did so in part because he had struck up a close relationship with Maurice Leenhardt.) Instead, he began to write of ‘a mystical mentality which is more marked and more easily observable among “primitive peoples” than in our own societies, but it is present in every human mind” (1975 [1949]: 100-1). The mystical mode of thought was both affective and conceptual, and had those features which he had attributed to ‘the law of participation’ all along: independence from ordinary space and time, logical contradictions (an object is both here and there), identity between objects and their arbitrary features (between hair cuttings and the person from whom they came, for example), and ‘the feeling of a contact, most often unforeseen, with a reality other than the reality given in the surrounding milieu’ (1975 [1949]: 108, 102). He thought that the mystical mode intermixed with everyday thought continually in our minds. He thought that the Kwakiutl switched back and forth between modes of thought as did the Catholic French. For him, the puzzle became, ‘How does it happen that these “mental habits” make themselves felt in certain circumstances and not in others?’ (1975 [1949]: 100).

This was in fact the puzzle that the English anthropologist E.E. Evans-Pritchard focused on in Witchcraft, oracles and magic among the Azande (1937) based on fieldwork in southern Sudan in the late 1920s. Evans-Pritchard was quite struck by the social importance of ideas about witchcraft in the community in which he lived. The Azande spoke and acted as if some people had special abilities. The angry and envious thoughts of those people could make other people sick, hurt their crops, delay their travel, and in general cause bad things to happen in their lives. Ordinary people also used a variety of techniques to divine who was bewitching them and how to protect themselves magically against them. In his ethnography, Evans-Pritchard set out the conditions which he thought could help to explain why the Azande did not notice why witchcraft, as he put it, did not really exist—that envious and angry thoughts did not in fact have this supernatural power. He suggested many reasons for Azande failure to notice the futility of their magic, among them the failure to generalise across situations, the disinterest in experimental technique, and so forth. His work gave rise to extremely active debates about modes of thought, the difference between science and religion, the nature of rationality, and so forth. It also gave rise to active discussions about why witchcraft beliefs emerged in some social worlds rather than others. Mary Douglas’s important edited volume, Witchcraft: confessions and accusations (1970) concluded that witchcraft beliefs were more often found in agricultural societies where social conflict cannot be easily resolved by moving, as it can be in hunter-gathering groups. The authors also found them to be more frequent in communities where the transition to power—such as being headman of the village—is unstructured, rather than being determined straightforwardly by being the headman’s first born son, for example.

These and other classic texts share the basic intuition that human awareness is imagined differently in different settings—and thus, that there is something particular about the representation of mind in the modern West. This sense of mind as a thing, as the seat of the self, as the driver of action, as something inner which is separate from an outer world; these are Western preoccupations, not Kwatkiutl, Canaque, or Dinka preoccupations. And although the authors quoted above made their claims broad and thinly sketched, the basic point seems right. A remarkable collection published in 1981 by Paul Heelas and Andrew Lock, entitled Indigenous psychology, laid out clear comparative evidence of different representations of mental experience. One essay, by Signe Howell, demonstrated that the Malaysian Chewong had very few vocabulary words for inner states. The Chewong certainly experienced emotion—but their social concerns circled around suppressing those emotions, and around their fear that the person who did not suppress was vulnerable to ghosts, spirits, and malevolent forces. In 1998, a dense article by Angeline Lillard in Psychological Bulletin summarised decades of ethnographic work to argue that the model of mind most psychologists took for granted was in fact quite culturally peculiar. The time seemed ripe for a structured comparative exploration of representations of mind and their consequences.

And then the work stalled. Little was written about the anthropology of mind for some three decades. Work in the area likely stalled for two reasons. The first is the shift in the temper of the times. Post-1960s anthropology ushered in an intense guilt about replicating colonial power dynamics in scholarly practice, and psychologically-informed inquiry, focused as it was on the intimate and the private, seemed the most egregious of unmerited intrusions. Michel Foucault began to dominate anthropology and anthropologists began to diagnose power asymmetries and to doubt their own capacity to observe. The second was the publication of a book that seemed to be undergirded with the new theoretical sophistication of cognitive science. C.R. Hallpike’s Foundations of primitive thought (1979) reported an observation made repeatedly about adults not schooled with Western education: they fail the standard tasks that indicate advancement along the cognitive path to adulthood in the West. They systematically fail tasks devised by Western researchers (like Jean Piaget and Alexander Luria) to test whether a child has cognitively advanced from early childhood to middle childhood. For example, in one task, the person taking the test is shown a tall thin glass from which water is poured into a short, fat glass and then asked whether the second glass contains the same amount of water. Younger children say no; older ones say yes. Hallpike carried out his work in a Melanesian village. With apparent regret, he reported that his adult villagers failed most of these tasks. When water was poured from a tall thin glass into a short fat glass, they said that the amount of water had changed. Hallpike was careful, thorough, and, seemingly, knowledgeable. He concluded that his adult villagers had the cognitive abilities of a preschool Western child. Most anthropologists were horrified. Although his conclusions were roundly criticised (Shweder 1982, Hamill 1985, Cole 2013), many younger anthropologists backed away from the comparative study of mind altogether.

To be clear, this apparent failure is deeply interesting. It suggests that the tasks embed assumptions about how children should respond to adults, what it means when adults question children, and so forth (see Greenfield 1997). It also suggests that there may be ways in which people in non-Western settings organise information differently than those in Western settings. In fact, this was the deep question raised by Claude Lévi-Strauss across his work (see especially Tristes tropiques [1955] and Wild thought [1962]). He argued that people without writing thought about history quite differently, and that they imagined that the world was limited to what they knew, rather than assuming that the world had many things which they did not yet know (imagining a ‘closed’ rather than an ‘open’ society). He compared the way Westerners thought to an engineer constructing large new buildings, and he compared ‘wild’ or ‘savage’ thought to the work of a bricoleur, a do-it-yourself handyman who solves problems with materials at hand. Lévi-Strauss was very clear that the cognitive capabilities of people living in small-scale and non-literate societies were as sharp as those of people in the West. In recent years, as cognitive science has emerged within the academy, some anthropologists (and psychologists) have begun to explore the question of how culture affects cognitive analysis (see overviews by D’Andrade 1995, Strauss & Quinn 1997, Henrich, Heine & Norenzayan 2010). They find that people in non-literate, small scale societie are equally cognitively capable as those in the modern West, but that their analytic styles can be quite different.

The anthropology of mind

In recent years, interest in culturally different models of mind has re-emerged as psychologically-inclined anthropologists have encountered a mature cognitive science which is increasingly concerned with cultural diversity. These days the ‘anthropology of mind’ is an emerging field which studies the way different representations of thought, awareness, and the mental shape the way people move in their world. Rather than only looking at performances and tests and asking how culture shapes cognitive process, the anthropology of mind asks what leads to different conceptions about thought and thinking, and how those differences matter. Psychologists have used the phrase ‘theory of mind’ to refer to the ways that children learn to draw inferences about other people’s minds (Gopnik & Meltzoff 1996). The anthropology of mind tends to use the term ‘local theory of mind’ to describe the cultural ideas about the mind that shape the ways that they draw those inferences.

Current discussions tend to assume the following points. They assume that all humans make some kind of mind-body distinction, but map it differently in different social worlds. Anthropologists are sometimes tempted to use the work of Lienhardt, Leenhardt, Howell, and so forth as evidence that mind-body dualism is an aberration of Western society, and that in many other social worlds people simply do not make the distinction. Indeed, one anthropologist, Rita Astuti, has described the idea that non-Western people are free of dualistic thinking as ‘one of anthropology’s favorite claims about cognition’ (2001: 429). Here is an example: ‘Gahuku notions do not parallel, but collapse, Western mind/body categories. For them … the body swallows and contains the mind’ (Strathern 1994: 45). And another: ‘Many (if not most) non-Western peoples … simply do not recognize anything comparable to the social/biological distinction as articulated by Western discourse’ (Ingold 1991: 362).

In fact, they do. The Malagasy Vezo studied by Rita Astuti speak as if they do not distinguish between nature and nurture, what is inherited by the body and what is learned through the mind. They insist that birth parents do not have exclusive rights to, or authority over, a child, and that resemblance between parents and children arises out of rich social involvement. The adult who cares makes the child. And yet when adult Vezo were asked to reason about the characteristics of an adopted child—with a story about parents attacked by bandits, a child left alone in the bush, found by another couple and loved—they clearly distinguished between bodily characteristics and mental ones. Astuti showed that they thought that the body of the adopted child would surely resemble her birth parents, but her thought and opinions were more like to resemble those who had adopted her. In another study, the Vezo systematically attribute more thinking and feeling capacities to a dead man (does he miss his wife?) than bodily capacities (does he get hungry?), the more so if they were invited to think about religion (Astuti & Harris 2008). These observations are supported by systematic work in other groups (e.g. Bering 2004, Cohen et al. 2011; see Weisman et al. forthcoming). The evidence strongly suggests that most humans recognise the difference between mind (broadly conceived) and body (again, broadly conceived).

At the same time, the evidence suggests that in different social worlds people draw the distinction between mind and body in different ways. We now see efforts to understand systematically how this human terrain is mapped differently by different cultures. Phillipe Descola’s grand comparative study, Beyond nature and culture (2013), for example, seeks to show that the culturally different representations of the human-nature relationship shape basic mental schemas through which humans apprehend the world. Descola asks:

But what is the form of this structural subconscious? Is it present in each mind in the form of cognitive imperatives that remain tacit despite being culturally determined, or is it distributed among the properties of the institutions that reveal it to the observer? How is it internalized by each individual and by what means does it act in such a way that it may determine recurrent behavior patterns that can be translated into vernacular models? (2013: 96)

He answers, in effect, that we know that there are cognitive schemas common to all humans yet internalised differently through experience in a specific social and environmental setting (2013: 103). Some of these culturally shaped schemas, or models, are consciously available to those in the group, but some are not. ‘Many cultural models are not transmitted as bodies of precepts but are internalized little by little, without any particular teaching, although this does not prevent them from being objectified quite schematically when circumstances demand it’ (2013: 103). The models become ‘the tacit frameworks and procedures of objectivization by means of which actors in the system themselves organize their relations to the world and to Others’ (2013: 110). The rest of his book is an ethnographic argument that there are deep differences in representation that follow the logic he lays out. Descola describes his comparative account as explaining the way the nature-human relationship shifts around the world. One might as easily describe it as a comparison of who is held to have minds: no one but humans (the West); everything, including rocks (Amazonia and other animist societies); some plants and animals which represent humans, but not all (Australian indigenous peoples and other totemic groups); a more contingent, shifting relationship (in other settings).

The Mind and Spirit project, a Stanford-based comparative and interdisciplinary project under my direction, also set out to understand differences in models of mind across settings (Luhrmann 2020a). This project drew on the expertise of anthropologists, psychologists, historians, and philosophers to ask whether different understandings of ‘mind’, broadly construed, might shape or be related to the ways that people attend to and interpret experiences they deem spiritual or supernatural. We took a mixed-method, multiphase approach, combining participant observation, long-form semi-structured interviews, quantitative surveys among the general population and local undergraduates, and psychological experiments with children and adults. We worked in five different countries: China, Ghana, Thailand, Vanuatu and the US, with some work in the Ecuadorian Amazon. In each country, we included a focus on members of urban charismatic evangelical churches, with additional work in rural areas and in indigenous religious settings of local importance.

The Mind and Spirit Project showed systematically that there are local theories of mind by interviewing and surveying people with similar probes about thinking and feeling. In Thailand, we found that many people held what could be described as a ‘kaleidoscopic’ mind. Felicity Aulino (2020) argued that her participants generally understood phenomenal experience as contingent on a host of factors, from personal habits to the influence of others. Here, sensory perceptions themselves were understood as in part a consequence of prior action (karma) and were shaped by their moral import. In Ghana, Vivian Dzokoto (2020; see also Dulin 2020a) identified four dimensions of an Akan theory of mind: that the central function of the mind is planning, not identity; that one of the most salient qualities of the mind is its moral valence (the ‘bad minds’ of others are an ever-present potential threat to social harmony and personal wellbeing); that the mind is porous in nature and vulnerable to supernatural influences; and in many ways, what English speakers would describe as mind are instead depicted as bodily. In China, Emily Ng (2020) found an urban Shanghai world in which many had adopted a Western-style bounded mind, which was seen as an obstacle in knowing God, while in rural settings the mind was represented as porous and God’s word carried immediate authority. Here, people deeply feared supernatural evil. In Vanuatu, Rachel Smith (2020) found what she called an ‘empowered imagination’. She thought that inferences about others’ intentions were not accorded a privileged role in social interaction. People thought about knowledge, creativity, meaning and intention not as confined to an inner mental domain, but as discoverable within the body, and in the world. Sensations on the left side of the body were taken as bad omens; sensations on the right side as good opens. The sight of a native kingfisher was a portent of death. There was little sense of a boundary between mind and world. In this context, the US model of mind (see Brahinsky 2020, Luhrmann 2012, Taylor 2007), did stand out: highly bounded in the sense that thought is supernaturally inert, and non-opaque (Robbins even calls it ‘transparent’) with a sense that the mind is a thing, the seat of the self, the driver of action, something inner which is separate from an outer world.

Dimensions of mind: porosity and opacity

Two dimensions along which different representations of the mind have emerged in the literature are opacity and porosity. Opacity (Rumsey & Robbins 2008, Robbins 2021) is the idea that one cannot know what someone else is thinking, feeling, or intending. Opacity statements are known to be common in many South Pacific societies—among them, the Yap (Throop 2010), the Korowai (Stasch 2008), the Urapmin (Robbins 2004), the Samoa (Duranti 1988), and others. In such places, anthropologists have been startled when they asked what seemed to be a routine question about someone not present, or drew a banal inference about such a person—was she walking to the store, or to visit her parents—and had been told that no one knew but her. These assertions are startling because in the anthropologist’s home setting, people often talk freely about other people’s intentions and motivations. Statements that one cannot know are at the least statements that one should not attempt to know, but an active debate centres on the question of whether these opacity doctrines can actually inhibit the human capacity to infer what others are thinking (Keane 2018).

Porosity is the idea that thought can seep from the mind and act with supernatural power in its own right, and that minds are vulnerable to the powerful thoughts of others, sometimes with the power to affect the entered mind. Many of us have some porosity intuitions. These include the idea that a dream carries information about the world that the dreamer could not have known, or that something of a dead person—particularly a murdered one—lives on in the house when they are gone. Porosity was introduced by Charles Taylor (2007) but has been developed and taken up by others (Luhrmann 2020b, Dulin 2020b) to capture the observation that in many social worlds, gods speak into the mind, and someone’s anger and envy can be harmful to others. Porosity is about mental causation. One of the central questions here is about how deeply supernatural and religious claims are held in awareness: whether claims about the Holy Spirit entering the mind, or witchcraft envy affecting other bodies, are held with the same cognitive attitude as facts in the everyday world. At the moment, the answer seems to be that while these supernatural claims might be fervently believed, they are likely believed in differently (van Leeuwen 2014, Luhrmann 2020). Another question is whether anger and envy are generally treated as more potent than love. At the moment, the answer appears to be yes (Legare & Gelman 2008).

Both opacity and porosity have real-world consequences. The degree of the social commitment to opacity shapes whether and how much one person shares with another. Middle-class Americans, for example, often believe that they should share everything with others—that nothing, not even anger or envy, should be held secret. That tends to be a central commitment of psychotherapeutic thinking, which is not oriented to opacity. Emotions not expressed will fester and cause harm. Opacity also appears to affect the way children respond to classic theory of mind tasks which ask them to draw inferences about what another person will think. In these tasks, the child is shown something that a third person does not know—that a toy, which is hidden, has been moved, or that a crayon box contains candy. Then the child is asked whether that third person knows where the toy is, or what is in the box. The child ‘passes’ when the child say no. Most children do pass theory of mind questions, everywhere, at some point. But in the South Pacific, children tend to pass later than children in the US, and some adults never pass at all (Wassman, Träuble & Funke 2013). More subtle analyses lay out the way children draw inferences about other people—learning that other people can have different desires, different beliefs, different knowledge access, false belief, and hidden emotion. In different social worlds, children grasp these possibilities in different orders. In worlds which value opacity, children are slower in passing standard theory of mind tasks, but far quicker than US children in learning that people can feel things they do not show on their faces (Wellman 2013, Dixson et al. 2017).

Porosity, meanwhile, undergirds religion and magic, but is not the same as either. One can be religious without believing in prophecy, the healing power of prayer, and so forth. Both magical and religious systems have a host of specific limitations: the magician or priest must use particular words, be trained in particular ways, and so forth. But the core idea of magic is that the magician’s intention acts in the world. That is why Stanley Tambiah (1973) could call magic ‘performative’: the act entails its consequence. Porosity, too, has more specific real-world consequences. The Mind and Spirit Project (Luhrmann 2020, Luhrmann et al. 2021, Dulin 2020) found that the more people endorse porosity ideas, the more vivid their spiritual experiences will be. The more they endorse porosity ideas, the more they report voices, visions, unusual presences—a range of sensorially vivid events. It is as if the commitment to the supernatural power of thought allows immaterial events to be felt as more substantial. A specific model of the mind seems to alter our visceral sense of what is real.

Recent anthropological work also offers evidence that local thinking about thinking has an impact on human experience that seems fundamental, although for the most part, anthropologists have not yet systematically organised these and other efforts around the question of how models of the mind might be related to human experience. Let us consider two.

First, medical anthropologists have shown that different models of mental action alter the symptoms of disease. Those who struggle with despair but do not imagine sadness as a legitimate cause of illness (as, for example, in China) are more likely to focus on joint pains and to experience them more intensely than those who take the mind’s action to be central (Kleinman 1986; Kirmayer 2001; Kitanaka 2011). Those with psychosis may not experience the symptom of thought insertion—the sense that a thought has been placed in one’s mind by another being—if, like the Iban people of Borneo, they do not imagine the mind as a container but as an action of the body (Barrett 2004). If the mind is a place where feelings can be held down like a monster under a trap door, then you should help someone who is unhappy by talking with them: you need to help them see that they are the keeper of the keys. If the mind is the emergent epiphenomenon of a pulsating brain, unhappiness is best treated by a chemical that alter those neural connections (Luhrmann 2000; Lakoff 2005; Makari 2015).

Second, anthropologists and historians have shown that Christianity’s doctrine of ‘inner assent’, or the emphasis on the importance of belief, contributed to a new individualism, although they argue about when the new individualism became apparent. The famous sociologist Max Weber (1930) located one shift at the birth of Protestantism, with what he called its unprecedented inner loneliness. Anthropologist Webb Keane (2007) follows his lead in focusing on Reformation efforts to purify the relationship between human and God so that it was not tainted by people, practices, and even words. Louis Dumont (1980) saw individualism in early Christianity but then emphasised the Enlightenment and its aftermath as the point at which individualism became socially salient. Medieval historians identify a shift from more collective notions of personhood to modern individualism in the tenth and twelfth centuries, with the new emphasis on the inner propelled both by theology and by the emergence of guilds and other groups (Morris 1972, Bynum 1982). But the source of the idea of moral person as an individual lies in the Christian text itself: Romans 10:10 states, ‘For it is with your heart that you believe and are justified’. The main point is that the idea that inner thought is more important than outward behaviour—in conjunction with some other changes—may have changed the way people thought about who they were. Notions of the mind may thus be of great importance for understandings of personhood.

Conclusion: the understanding of mind in the West is peculiar

One important point that emerges from anthropological studies of the mind is that Western, post-Enlightenment ideas about the mind are unusual in the context of world cultures. By this I mean the idea that the mind is bounded (thoughts do not have supernatural power, and they do not leak of their own accord into the world and into someone else’s body) and that the mind is non-opaque (people think it is appropriate, even healthy, to ask about and seek to know what other people are thinking) are unusual when considered against ideas about the mind in other social worlds. I also mean that the idea that mind is sharply distinguished from the body and greatly important as a source of personal identity—that what you think and feel makes you ‘you’—is unusual. In psychology and medicine, these expectations about mental life are often taken to be straightforwardly natural, as the way mental life is experienced by all (see D’Andrade 1987). To be sure, some scholars have noted its historical specificity. They have explained the peculiarity of this Western model of the mind in different ways: as the effect of capitalism (Dumont 1992, Macfarlane 1993), Protestantism (Weber 1905, Keane 2008), secularism (Taylor 2007), and the idiosyncratic individualistic family structure of the West (Goody 1983, Henrich 2020). It is also clear that these ideas have political consequences. To count as fully human, a person has had to demonstrate full rationality—a goal thought for many years to be unachievable by persons with a different skin colour, and by women, among others. These matters deserve our attention. They are of profound social relevance.

Christina Toren (1993) was one of the first to call for a comparative anthropology of mind. Only once we grasp the degree to which our fundamental concepts of the mental shape our understanding can we appreciate that all humans are not only creatures with bodies but also with history, and that this history shapes us so deeply that, like a fish surrounded by water, we forget that it is there.

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Note on contributor

Tanya Marie Luhrmann is the Albert Ray Lang Professor at Stanford University, in the Stanford Anthropology Department (and Psychology, by courtesy). She was elected to the American Academy of Arts and Sciences in 2003 and received a John Guggenheim Fellowship award in 2007. She is the author of When God talks back (2012, Knopf) and How God becomes real (2020, Princeton University Press) and is currently at work on a book entitled Voices.

Depression

Rebecca Tishler — Tue, 30 Mar 2021 18:40:59 +0000

Junko Kitanaka Stefan Ecks

Keio University & University of Edinburgh

Initially published 30 Mar 2021

http://doi.org/10.29164/21depression

Abstract:

Depression, which psychiatrists regard as a most common mental illness, has been examined by anthropologists especially closely since the 1980s. While most medical experts consider depression as a universal, neurobiological disease that requires a global public health intervention, anthropologists instead ask why the illness known in psychiatry as ‘depression’ appears to have been extremely rare in much of the world until very recently. They also investigate how a supposedly neurobiological disorder could possibly arise with increasing frequency in so many places in such a short time. Some anthropologists suggest that the apparent rise of depression is co-constituted by changes in diagnostic criteria, a medicalisation of normal distress, as well as the growing influence of the global pharmaceutical industry. They have questioned the assumption of a clear-cut border between normalcy and abnormalcy, illuminated depression’s social origins, and problematised the extension of medical power into spheres of life that used to lie beyond the reach of medicine. This entry shows how anthropologists investigated depression before and after its alleged global rise in the 1990s, and how this phenomenon can be understood as a cultural, historical product profoundly influenced by socioeconomic transformations of the current time.

Introduction

Depression, which psychiatrists define as a constellation of low energy, low self-worth, and low mood, has emerged as a global concern since the 1990s. Calculated in terms of disease burden through disability-adjusted life years (or DALYs), depression is deemed the world’s second most common disorder after cardiovascular disease (Murray et al. 2013). It reportedly affects more than 264 million people worldwide (Ritchie & Roser 2021). Most medical experts and epidemiologists consider depression to be a universal, neurobiological disease that requires a global public health intervention. Anthropologists, on the other hand, ask why the illness known in psychiatry as ‘depression’ appears to have been extremely rare in much of the world until very recently, and how a supposedly neurobiological disorder could possibly arise with increasing frequency in so many places in such a short time. Some anthropologists suggest that the apparent rise of depression is co-constituted by changes in diagnostic criteria, a medicalisation of normal distress, as well as the growing influence of the global pharmaceutical industry. Anthropologists tend to be critical of biologising perspectives that see moods and emotions as the same across the world, irrespective of cultural and social contexts (Ecks 2016).

This entry will survey some anthropological works on the subject before and after the alleged global rise of depression in the 1990s. The ascent of depression mirrors that of suicide, which was a global concern at the turn of the twentieth century, leading to its sustained epidemiological study and a theory of individual mental distress as a symptom of collective malady (Durkheim 1952 [1897]). The rise of depression at the turn of the twenty-first century has provided a fertile ground for new anthropological concepts and ethnographic approaches. This entry will show how anthropologists have frequently questioned the assumption of a clear-cut border between normalcy and abnormalcy, illuminated depression’s social origins, and problematised the extension of medical power into spheres of life that used to lie beyond the reach of medicine. Anthropologists tend to challenge biomedicine’s one-size-fits-all prescriptions for treatment and its underlying assumption that a person with symptoms of depression can be treated as an individualised and decontextualised being, cut off from social interactions and complex power relations (Kleinman & Good 1985). The entry also examines the historical implications of the current rise of depression by considering its relationship to wider socioeconomic transformations, including the neoliberalisation of selfhood.

Culture, gender, and situated biologies

If few psychiatrists dispute the universality of depression today, it was still a matter of debate in the mid-twentieth century, when the level of depression reported from most non-Western societies was low. Some psychiatrists even wondered if depression was a culture-bound Western illness, which they saw as reflecting a supposedly more mature and introspective Western self (see Littlewood & Dein 2000). This model of depression derives in part from the Western concept of melancholy that preceded it and that is rooted in Greco-Roman humoral medicine. Melancholy was not just a pathology, but was also seen as a source of reflexivity and creativity (Jackson 1986, Radden 2000). This line of thinking led some psychiatrists to assume that the relative lack of depression among non-Westerners was a sign of their immaturity and lack of insight, even a lack of Christian guilt, which made them immune to depression (see Littlewood & Dein 2000). One of them even echoed Jean-Jacques Rousseau's theme of ‘noble savages’ in claiming in a WHO report that Africans were not prone to depression because of their ‘lack of responsibility’ (Carrothers 1953, cited in Beiser 1985: 273).

Residue from these racialised and ethnocentric ideas continued to be found in later twentieth century psychological and psychiatric discussions that depicted Westerners as introspective and intellectually articulate ‘psychologisers’ and non-Westerners as unreflexive and more instinctual ‘somatizers’ (see White 1982). They explained the relative absence of depression among non-Westerners in terms of their alleged incapability in recognising psychological distress, which would instead be expressed as bodily symptoms (for criticism, see White 1982 and Kirmayer 1999; Ecks 2013, Kleinman & Good 1985). Women and the working class tended to be depicted as ‘somatizers’ well into the late-twentieth century (see Kirmayer 1999), speaking to the continuing presence of gender, class, and ethnicity biases in the psychiatric discourse about depression.

Anthropologists made a case against conventional psychiatry by arguing for the ‘work of culture’ (Obeyesekere 1985). They showed that local habits and traditions, such as Buddhism, can protect people from depression by transforming negative affect into publicly acceptable narratives and symbols. In an influential yet controversial article, Gananath Obeyesekere (1985) discussed the case of a Sri Lankan man whom psychiatrists would diagnose with depression but who, in a Buddhist context, was revered for achieving enlightenment because he saw the world as full of suffering. No society distinguishes categorically between mental illness and health (Keyes 1985). Sorrow and grief are often linked with inner depth and dignity, not pathology (also see Good, Good & Moradi 1985). Given these alternative perspectives of experiencing the world, some anthropologists argued that the high rate of depression in the US was a product of an American ethnopsychology that prioritises the constant pursuit of happiness as a basic aim of human existence (Lutz 1985).

One important instance of historical and regional variations of depression is its gender ratio. Although depression today is said to affect women twice as much as men, even in the West at the turn of the twentieth century, elite men used to be depicted as more prone to depression (as an illness of reflexivity) than women. For women, a diagnosis of hysteria was more likely (Showalter 1985; Raden 2000; see also Metzl 2003). Cultural perceptions of women in distress, and the ways in which people perceive and engage with these women, are associated with regional prevalence of depression, along with symptom-reporting and help-seeking behaviours. For example, postpartum depression is a major public health issue in the US and Europe, but it is not universally discussed or even recognised elsewhere. Anthropologists have found that a social and ritual structuring of the postpartum period protects women from depression. This structuring includes ‘1) protective measures and rituals reflecting the presumed vulnerability of the new mother; 2) social seclusion; 3) mandated rest; 4) assistance in tasks from relatives and mid-wives; and 5) social recognition through rituals, gifts, etc. of the new social status of the mother’ (Stern & Kruckman 1983: 1039). The authors also suggested that regional differences in prevalence might stem from the fact that most cases of postpartum depression are mild, not psychotic, and that such milder forms of depression are more easily shaped by cultural influences (Stern & Kruckman 1983).

In a study that introduced the influential concept of ‘local biologies’ (later redefined as ‘situated biologies’), Margaret Lock (1993) argued that experiences of disease and illness need to be understood as products of interplay between individual biology and sociocultural environment. Lock noted a statistical anomaly in the WHO’s cross-national depression survey, which reported that Japan not only showed lower rates of depression than its Western counterparts but that it was the only country included in the survey where slightly more men than women appeared to suffer from depression (Sartorius & WHO 1983). She explored this epidemiological puzzle by researching women at menopausal age in Japan and North America, and argued that an individual’s genetics, lifestyle (including diet), social environment, and culture interact to create vastly different experiences of aging. Combining epidemiological and ethnographic methodologies, Lock also showed that the lower rate of depression among menopausal Japanese women was because they did not recognise ‘depression’ as such, and regarded menopause as part of a natural aging process. Importantly, the women in Lock’s study, even those in trying socioeconomic circumstances, kept telling her that their suffering was insignificant, that they were even ‘fortunate’, when compared to their own mothers, who had survived WWII and its aftermath. This cultural, collective rendering of their suffering seemed to protect women from medicalisation, which would have turned natural processes of living and aging into matters for biomedical intervention.

The studies mentioned so far show that individual biologies are heterogeneous as they are formed out of particular local contexts, which also intersect with local politics of recognition and legitimisation of people’s distress. Examining how certain symptoms and certain types of suffering elicit more sympathy and concern from others, anthropologists help to explain differences in prevalence rates of depression as well as in health-seeking behaviours and care provision. In Lock’s study, for example, local politics that had an important, protective aspect for many women in distress also meant that the suffering of some other women, who did experience severe symptoms of menopause or depression, was often rendered invisible and left untreated, increasing their physiological and psychological pain. Given that cultural discourse can be a double-edged sword, anthropologists pay close attention to the fact that local forces do not have the same effects on all people. At the same time, reducing depression to these women’s physiological differences and/or neurochemical imbalances would be to omit, among other things, the socioeconomic environment and local gender politics that structure their distress in the first place^.[1]

Distress, misunderstandings, and the politics of psychiatry

Recognising that people in much of the world experience and express their distress by means other than the psychiatric concept of depression, anthropologists from the 1980s began employing the notion of ‘idioms of distress’ as culturally diverse ways of expressing psychosocial distress (Nichter 1981). This concept has proven highly productive for clinicians as well, as the term ‘idiom’ does not presuppose pathology and can be used to capture a wide range of local experiences, symptomatology, and help-seeking behaviours that might previously have gone unnoticed (see Lewis-Fernando & Kirmayer 2019). Mapping out regional idioms, anthropologists found depression-like experiences expressed in a wide range of descriptions of nervous conditions such as ‘nervos’ in South America, ‘nerve exhaustion’ in East Asia, as well as other psychophysiological idioms like ‘heart distress’ in the Middle East. They noted how common these depression-like symptoms were across cultures when they included somatic expressions of psychosocial distress, leading them to question the definition—based in Western psychiatry’s mind-body dualism—that defines depression predominantly as a disease of the mind (also see Marsella 1982, Kleinman 1988, Ecks 2021).

National politics and state medical systems also help shape distinctive forms of medicalisation. In a pioneering work on this topic, Arthur Kleinman’s ethnography of China (1986) showed how a particular Chinese usage of ‘neurasthenia’ (a psychiatric term for depression-like symptoms common at the turn of the twentieth century) emerged in the 1980s as part of a powerful, state-sanctioned discourse, unthreatening to the political status quo. Showing how people used this idiom to channel their anger against injustice suffered during and after the Cultural Revolution, Kleinman proposed an analysis of medicalisation that moved beyond the idea of a top-down process of labelling and social control by medical professionals. Instead, he demonstrated how medicalisation can be a bottom-up process, where people’s desire for social recognition of their suffering is intrinsically linked with state/biomedical legitimisation, which together produce an ambivalent form of liberation and empowerment for those in distress (cf. Yang 2018 on the official, individualising usage of ‘depression’ in China today).

Local notions of depression do not merely remain at the level of popular or folk knowledge but in fact shape and are shaped by professional psychiatry, which shows remarkable regional variation. This became apparent when a US-UK comparative study (Kendell et al. 1971) showed that, given the same set of symptoms, American psychiatrists were far more likely to diagnose schizophrenia while their British counterparts were more likely to diagnose manic-depression. Such differences in localised theories and practices are also expressed in the varying ‘prototypes’ of depression, or psychiatric ideas about what or who constitutes a ‘typical’ case (Young 1995). The typical subject of depression in Japanese psychiatric literature, which developed in close dialogue with the German psychiatric concept of typus melancholicus, has long been regarded as a burned-out white-collar worker, in sharp contrast to the North American psychoanalytic prototype of depression as an illness of melancholic housewives (Kitanaka 2012). Even at the level of hard scientific terms, depression is a malleable, multifaceted idea, and psychiatric language remains inextricable from the reality that it co-creates the illnesses it attempts to represent (Foucault 1973 [1961], Hacking 1999).

The heterogeneous nature of depression at the local level often goes unaddressed in biomedicine, in part due to the division between medical science and psychiatric practice (Young 1995, Luhrmann 2000). As Allan Young (1995) has shown, medical science, at its core, depends on a paradigmatic ‘style of reasoning’ (Hacking 1982) with a remarkably stable body of knowledge and ideologies about objectivity and universality; clinical medicine, on the other hand, remains protean and multiplicitous, working in tandem with local knowledge and discourse. A scientific style of reasoning provides practitioners with a sense of stability, order, and coherence via an understanding that not all scientific facts have equal ‘truth’ values (Gilbert & Mulkay 1984, Young 1995). Scientific psychiatry (i.e. research-based, academic psychiatry) emanates from only a handful of European and North American power centres and spreads to the ‘periphery’, while clinical psychiatry frequently remains a ‘local knowledge’, rarely traveling to the knowledge-production centres of scientific psychiatry (Cohen 1995). Communication is mostly unidirectional, and when medical science further distances the data from the world of local clinical practice, patients’ individual stories are replaced by fragments of voiceless material bodies in the laboratory. At this stage, the lack of dialogue between scientific psychiatry and local practice becomes more gravely problematic (Young 1995).

Given the power asymmetries in scientific psychiatry, ‘discovering’ depression in the non-West and imposing a decontextualised and universalised Western concept of depression on these societies may amount to a ‘category fallacy’. That is, it may give seemingly universal legitimacy to a culturally constructed concept and its use among those engaged in cross-cultural research (Kleinman 1977, Lutz 1985). Kleinman (1988) cites Obeyesekere (1985) in discussing the culture-bound syndrome among Southeast Asian men called dhat, a feared ‘semen loss’ that results in draining energy and weakness (Ecks 2013). Kleinman and Obeyesekere show how absurd it would seem to Westerners for psychiatry to adopt the concept, standardise it, train psychiatrists globally to correctly diagnose it, educate the public about it, and work with pharmaceutical companies to invent and market a drug for it. To most observers, this would create unnecessary anxiety and a desire for therapeutic treatment for an illness that does not exist as such. Yet when it comes to Western psychiatric concepts such as depression, a similar process is normalised and might even be praised as a form of medical humanitarianism. This is because depression is regarded by the Western psychiatric establishment as a ‘real’ phenomenon, but semen loss is not. Psychiatry has also been criticised for depending on databases mostly developed with and for the ‘mainstream population in Western societies’ (i.e. ‘middle class whites’) and naively applying it to all other people (Kleinman 1988: xii). Given such subtle but important power disparities, the anthropologist’s job is to attend to differences and ask how local knowledge is produced and what remains ‘local’, how local and global psychiatry might communicate with one another, and how local psychiatric concepts might influence the production of global and scientific psychiatric knowledge (Cohen 1995; also see Pentecost et al. forthcoming).

Globalised depression

Sensitivity to local differences has become more important than ever with the global rise of depression since the 1990s. Previously understood as a culture-bound syndrome of the West, depression has become regarded by many as a universal disease of epidemic proportions. This change was brought about partly by the broadening of the concept of depression in the DSM-III (The Diagnostic and Statistical Manual of Mental Disorders, Third Edition, published in 1980), the development and marketing of a new generation of antidepressants, and the movement for global mental health. As anthropologists working in places where depression used to be rare witnessed its sudden rise, they began documenting the ‘making of depression’ on the ground, or the process by which a constellation of low energy, low self-worth, and low mood comes to be regarded as a clinical symptom and then a disease. In analysing these processes, they have often used Ian Hacking's (1995) notion of a ‘looping effect’ in which people’s experience living with the label of depression alters how they experience the condition itself. As the label is more frequently applied, people appear to change in ways that affect both how depression is classified and how people describe and live with it (Hacking 1999). Such changes prompt us to wonder if psychiatric globalisation serves to erase regional theories and homogenises understandings of depression.

Initially, many social scientists, psychiatrists, and philosophers were particularly concerned about the global spread of antidepressants even to areas where depression had not been widely recognised. They noted that pharmaceutical companies carefully tailored their marketing strategies to cultural contexts by employing the most effective local idioms of distress in promoting antidepressants. Thus, they spoke of ‘mind food’ in India and of ‘a cold of the soul’ in Japan (Ecks 2013; Kirmayer 2004, Applbaum 2006). Critics worried that the aggressive marketing of pills like Prozac might serve to replace pre-existing local understandings with biomedicalised approaches to depression. This, they thought, might instil a concept of a neurochemical self (Rose 2007), making people think that ‘we are our brains’, possibly impoverishing our understanding of human nature (see Vidal & Ortega 2017; also see anthropological critiques of neurobiology and how to integrate it with an ecological perspective in Raikhel 2015). Such biological reductionism, occurring in the era of neoliberalism, might further create ‘happy’ productive workers, who voluntarily soothed their dissent with pills in exchange for the illusion of control.

However, anthropologists have since discovered that both lay people and diagnosed patients are usually not fully persuaded by such biological reductionism (Vidal & Ortega 2017, Elliott 2003). Therapeutic effects of drugs do not just rely on neurochemical change but also on cultural attitudes (Rose 2007: 100; Ecks forthcoming). While American discourse initially suggested that people could recover their ‘true selves’ through the use of antidepressant medications (Kramer 1993), in Argentina, antidepressants were offered as treatment for symptoms which were understood to be political and economic ills (Lakoff 2005). In India, psychiatrists linked antidepressants with widespread cultural notions around nutrition, digestion, and somatic balance, encouraging patients to see them as moner khabar (‘mind food’; Ecks 2013). In Pelotas, Brazil, economically-poorer youth tended to use antidepressants for longer periods and in a long-standing interpretive frame that encouraged them to subtly internalise the assumption that their psyches are inherently weak and immature. In contrast, middle-class youth used antidepressants to temporarily facilitate the crucial work of refashioning a resilient internal self. These different uses served to reinforce long-standing views of the psychological inferiority of marginalised populations (Béhague 2015). These wide-ranging discourses surrounding antidepressant use demonstrate that, despite its globalisation, depression continues to be a localised ‘polysemic symbol’ (Barrett 1988: 375) in which ‘various meanings and values are condensed into a syndrome’ (Lock & Nguyen 2010: 73).

Even in the US, where antidepressants like Prozac were initially hailed as magic happiness pills during the 1990s, scepticism grew about whether it was wise to even try to achieve such constant happiness. Leading psychiatrists began to debate whether the pharmaceuticalisation of everyday distress might render people less tolerant of negative emotions such as sorrow and grief, leading to what Allen Frances, the chairman of DSM-IV, called the ‘loss of sadness’ (Frances 2013). Many critics are concerned about how the loss of what was previously considered ‘normal’ sadness could weaken the traditional resources people have used to confront hardship or loss (for example Elliott & Chambers 2004). This debate was heightened when a crucial clause in the DSM-5, which used to make an exception for bereavement in the diagnosis of depressive disorder, was altered. Since 2013, even people dealing with a loved one's death can receive a diagnosis of depression (Ecks forthcoming). As Kleinman and others have argued, no reliable scientific evidence exists that can determine how long a 'normal' bereavement period should be (Kleinman 2012). These psychiatrists warn that when even grief is made an object of pharmaceutical intervention, resulting social pressure means pharmaceutical treatment of depression is normalised.

The recognition of the limitation of pharmaceutical cures has led to the flourishing of other psychosocial interventions and local reflections about the nature of depression. In post-dictatorship Chile, both antidepressants and group psychotherapies are offered to the poor as part of the National Depression Treatment Program, aimed to combat the world’s second highest prevalence of depression. Clara Han (2012) shows, however, that women living in poverty see such neuropsychological intervention as little more than a temporary respite with little efficacy for solving their everyday struggles. As these women bear the burden of redeeming themselves both from the nation’s traumatic past and the economic precarity brought on by radical monetary policies, they discuss depression as embodying the interconnectedness of domestic troubles, debts, and social insecurity, problems for which neuropsychology has little to offer (Han 2012). Similarly, in Iran, depression has served as an idiom for working through generational traumas, where the past memories of the revolution and international conflicts are woven together to express today’s collective and personal predicaments (Behrouzan 2016). The rise of psychotherapy in Mexico (Duncan 2018) and China (Zhang 2020) since the 2000s has helped cultivate people’s desire for an ‘entrepreneurial self’, even as it seems to also generate a space for reflecting on the psychological toll that this new self may bring. These regional discourses about depression suggest that medicalisation can provide a ‘structural possibility’ (Corin 1998) for people to detach from and reflect on pathogenic cultural expectations and to effect important social transformations.

Signs of profound structural changes can be found in areas where depression has been widely debated as an illness of labour and a problem of productivity at the national level (on economy and depression, see the classic sociological work by Brown & Harris (1978). The increasing number of distressed workers in Finland sparked a public concern as it was seen as a sign of the decline of the welfare state (Funahashi 2021). A diagnosis of depression has become a weapon of the weak for signalling their socioeconomic precarity and social pathology in Italy, where the debate about workplace bullying and workers’ psychopathology, including depression, arose. As people place the blame on neoliberalism, which they see as destroying their culture of safeguarded work, ‘mobbing experts’ are engaged to diagnose and intervene into the high stress level of the workplace, paving a way for a solution at an organisational, structural level (Mole 2010). The national debate regarding ‘overwork depression’ and ‘overwork suicide’ in Japan has turned these diagnoses into powerful tools workers and families can use to highlight the dire cost of work stress and emotional labour on their health. After medico-legal debates about the exact cause of depression—whether it is a problem of workers’ neuropsychological vulnerability or a pathogenic environment—the government has changed labour policies to remedy the psychologically toxic work environment. At the same time, work is seen as both a cause and a cure for depression, as new forms of surveillance technologies and occupational therapies have emerged as ways for managing and recovering the depressed (Kitanaka 2012; also see Bowen forthcoming on the near-absence of depression among ‘occupational mental disorders’ in Chile).

Global therapeutics: quantified selves, resilience, and anonymous care

The advent of digital psychiatry is shaping a global platform for the prevention of depression. This also raises concerns about novel forms of biomedical surveillance. While recording one’s moods has long been part of a psychiatric treatment for depression (Martin 2007), the accessibility of digital technologies today is encouraging more and more people to keep track of their biorhythms, cognitive patterns, behavioural habits, and moods (Ecks forthcoming). Digitalised neuropsychological management and interventions now include computer software that can quantify stress via heart rate through interaction with input devices. These prevention and early intervention technologies expand the number of people who begin to identify with the idea of the ‘quantified self’, which refers to both self-tracking technology and the community of users of such tools (Lupton 2016). While these tools can be empowering for those who want to be in control of their own health, such technologies might have the effect of taking depressed people out of the emotional realm and the particular social contexts where they feel their symptoms, and relocate them to the public, quantifiable realm of human engineering and rational management (Kitanaka 2015). Compared to previous forms of therapeutics technologies that often incorporate historical reflections on the nature of one’s predicament, these digitalised systems of state/corporate/market ‘care of the self’ (Foucault 1990, Foucault et al. 1988) are far from engaging with social origins of depression and largely remain at the level of merely encouraging individual transformation (cf. Borovoy & Zhang 2017). The spread of such therapeutic/surveillance technologies prompts us to ask whether they will end up reshaping social understandings of depression within the discursive limits of biopsychiatry, with its tendency to depoliticise illnesses and promote ideologies of individual responsibility and commodified health (cf. Comaroff 1982, Gordon 1988; also see Lovell & Susser 2014.).

Enhancement technologies for the depressed are another facet of emerging global therapeutics. To keep patients from developing depression and to help them recover from it, medical professionals based in the world’s power centres increasingly emphasise resilience, a seemingly benign concept, as well as ‘resilience training’, with the stated aim of rendering people better able to handle stress. Particularly in the US, the military promotes positive psychology through resilience training and encourages soldiers to adopt a positive attitude as a tool for becoming more psychologically ‘fit’ (MacLeish 2013). Resilience glamorises the individual’s transcendental power, which creates a potent lure for adopters. At the same time, it renders people’s ability to independently recover from distress and live healthy lives into a therapeutically managed process. Young points out that handling everyday stress is being redefined as ‘something to be achieved with the help of experts’, so much so that resilience might, before long, ‘displace effortless “normality” as the default condition of human life’ (2012, 2014). Emily Martin (2007) shows how even mania, the opposite pole of depression, is now fetishised and commodified in corporate America as a source of creativity and high productivity. As some companies offer training to boost both one’s manic power while maintaining healthy mood cycles, mood disorders like depression may become an entry point to one’s subjectivity for experts promoting the further corporatisation of psychological health (also see Chua (2011) on resilience training for suicidal youths in Kerala).

As suicide is said to kill one person every 40 seconds,^[2] treating depression as a way of preventing suicide has also become an urgent global issue. Globalising suicide prevention programs often take a universal form, despite the fact that their efficacy at the local level is often left unexamined. Problematising this and illuminating the high rates of suicide in the Canadian Arctic, Lisa Stevenson (2014) investigates the persistently high rate of suicide among Inuit youths, in particular, despite all the care that is given to them. Going beyond psychiatric conceptualisations of suicide and tracing Canada’s history of ‘welfare colonialism’, she identifies one problematic factor in care services driven by mechanical, bureaucratic rationality—what Stevenson refers to as ‘anonymous care’—whereby ‘it doesn’t matter who you are, just that you stay alive’ (Stevenson 2014: 7, emphasis in original). Questioning this form of humanitarianism, she criticises the global suicide prevention programs that seek to define at-risk populations and provide a set of protocols that would enable volunteer carers to deal with suicidal individuals at a distance, without needing to invest themselves in the specificity of those individuals’ suffering. The distance and anonymity afforded through this approach provides a certain freedom for both parties, but it also renders the suffering individual into a depersonalised ‘case’. Stevenson discusses how these Inuit youths, a group all too often regarded as a ‘problem’ to begin with and who are ultimately not well served by the humanitarian care provided to them, come to see in suicide a ‘leap into another way of being in time’ (Stevenson 2014: 147)—and asks how they can begin to reconstruct themselves in an alternative regime of life, one that recognises other ways of living and dying (also see O’Nell 1996; Davis 2012, Garcia 2010, Meyers 2013).

Depression and neoliberal selfhood

In asking what might be the universal implications of the global spread of depression, let us take a step back and ponder the broader historical meaning of the rise of the neuropsychological management of the self. Sociologist Alain Ehrenberg (2010) argues that depression is the typical disorder of the current era. Ehrenberg’s analysis focuses on understandings of mental illnesses from the 1900s to the 2000s. Social relations have changed from more hierarchical to more egalitarian, with a more equal distribution of wealth and status. In the 1900s, the prototypical mental conflicts came from struggles with authority and from deviance from clearly defined social norms. Conflicts lay between people. Since the second half of the twentieth century, flattening social hierarchies enhanced inner conflicts about motivation and decisiveness. Since then, conflicts lie within people's own selves. Ehrenberg describes how, today, all decision-making has to be done by oneself, within oneself. In other words, the rise of depression has to do with this fatigued self at a time one has to make so many decisions (Ehrenberg 2010: 223).

Building on Ehrenberg’s argument, Stefan Ecks (forthcoming) analyses the new regime of ‘neoliberal self’ that serves to extend market competition within the self. According to Ecks, neoliberalism accelerates the dual process of fewer social distinctions coupled with an intensified drive at self-enhancement and becoming an entrepreneur. In earlier forms of capitalism, the goal of all this striving was the accumulation of capital through ascetic self-denial (Weber 2010 [1904/05]). In neoliberalism, the goal is not self-denial but self-satisfaction, even its maximisation. Homo economicus replaces outside partners of exchange with his own inner self (Foucault 2008: 226; Rose 1990; Brijnath & Antoniades 2016; Hardt & Negri 2017; Martin 2007). As the self takes itself as its own competitor in a market for getting the best deal from every moment of life (Scharff 2016), this creates a pathogenic condition where one feels that one can never do enough, never improve enough. Slow or stalled decision-making becomes a dreaded symptom; inability to act becomes a pathology of the current era (Leykin & DeRubeis 2010), which may have contributed to the global rise of depression.

The global desire for therapeutics from depression is thus a search for a new form of psychological governance. Ecks (forthcoming) argues how depression’s main symptoms—of devaluing oneself, devaluing one’s life possibilities, and having no motivation or energy to enhance life—all go together in this new regime of self. He points out that, just as much as sadness, depression is associated with being numb and without emotional sensitivity. As emotions guide decisions, they literally move the person ‘out’ from where they are. The numbing of emotions makes deciding harder, not easier. To live is to value, and to value means to feel, with the whole body, that one thing is better than another thing (Ecks forthcoming). The numbness of emotion is also another symptom, where affective indifference can lead to indecisiveness (Ratcliff 2015). Thus a recovery from depression involves recovering emotions, and all forms of therapy involve giving people the belief that they can heal and that alternatives to the current impasse exist (Csordas 2002; Hinton & Kirmayer 2017). As the feeling of hopelessness is related to not being able to imagine a better future, or to believe that improvement could be possible, recovering from depression means regaining the ability to see different possibilities for action as possible. How such therapeutics can be made available is a question that needs further investigation.

Conclusion

The global medicalisation of the concept of depression points to the ‘maximum universality’ of depression, whereby it has become an object of biopsychological, scientific investigation. At the same time, it highlights depression’s extreme heterogeneity (Ehrenberg 2010: 74). As a result of the plasticity of the notion of depression, it has been subjected to widely varying local interpretations and responses. Psychiatry has largely aligned itself with the universalist stance, emphasising genetic and neurobiological research and promoting methodological individual reductionism. Anthropology, in contrast, illuminates the vast variation of depression experiences across time and space, thereby providing a key counterpoint to reductionistic psychiatric views on causality and personhood (Kleiman 1988, Kirmayer 1999). The fact that biomedicine as a whole has shifted away from simplistic models of genetic determinism (Lock & Pálsson 2016, Rose 2018) suggests possibilities for collaborative engagement between psychiatry and anthropology that may encompass both biological and sociocultural views of depression (Kirmayer et al. 2015).

Anthropologists, with their historically strong interest in local life worlds and native points of view, have shed light on dimensions of depression that may not be easily accessible through a psychiatric lens. Such perspectives are becoming more important than ever given the politics of medicalisation today, as a multiplicity of social actors and institutions including psychiatrists, lawmakers, governments, pharmaceutical companies, and NGOs all exert their own ideas as to the nature of depression and how best to respond to it. This heterogeneity of views on depression—and indeed on human nature—provide the backdrop to anthropological research on the subject that is at once multifaceted and nuanced. As depression allows no easy answers to questions about its causality or effective cures but seems to touch more and more people as part of the spread of capitalism, it will continue to be an important focus for further investigation and ethnographic engagement.

Note

Parts of this paper are adopted from Kitanaka (2012). Junko Kitanaka’s further research was funded by JSPS Grant-in-Aid for Scientific Research (C) 19K01205.

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Note on contributors

Junko Kitanaka, is a professor of medical anthropology in the Department of Human Sciences, Faculty of Letters, at Keio University in Tokyo. Her book Depression in Japan: psychiatric cures for a society in distress (2012, Princeton University Press) has won the American Anthropological Association’s Francis Hsu Prize in 2013 and has been translated into French. She has served on the Board of the American Society for Medical Anthropology and numerous editorial boards, including Cultural Anthropology. She is currently working on new projects on dementia, preventive psychiatry, and the medicalisation of the lifecycle.

Professor Junko Kitanaka, Department of Human Sciences, Faculty of Letters, Keio University, 2-15-45 Mita, Minato-ku, Tokyo 108-8345 Japan. junko.kitanaka@keio.jp

Stefan Ecks co-founded Edinburgh University’s Medical Anthropology programme. He teaches social anthropology and directs postgraduate teaching in the School of Social & Political Sciences. He did ethnographic fieldwork in India, Nepal, and the UK. Recent work explores value in global pharmaceutical markets, changing ideas of mental health in South Asia, poverty and access to health care, as well as multimorbidity. Publications include Eating Drugs: Psychopharmaceutical Pluralism in India (New York, 2013), Living Worth: Value and Values in Global Pharmaceutical Markets (forthcoming), as well as many journal articles on the intersections between health and economics.

Dr Stefan Ecks, School of Social and Political Science, University of Edinburgh, Chrystal Macmillan Building, 15a George Square, Edinburgh EH8 9LD, UK. secks@ed.ac.uk

[1] See Neitzke 2016 for a critique of the harm of biological reductionism in research on women and depression.

[2] Suicide: one person dies every 40 seconds. World Health Organization. News release. 9 September 2019 (available on-line: https://www.who.int/news/item/09-09-2019-suicide-one-person-dies-every-40-seconds).

Addiction

Rebecca Tishler — Wed, 21 Oct 2020 01:14:10 +0000

Joshua Burraway

University of Virginia

Initially published 21 Oct 2020

http://doi.org/10.29164/20addiction

Abstract:

What is addiction? As an umbrella term, addiction is often used to describe activities where there is an overwhelming drive to engage in destructive, distressing or compulsive behavioural patterns, including not just drug-taking and drinking, but gambling, eating, sex, video gaming, and even shopping. Whilst all these activities have generated rich fields of inquiry across the social science disciplines, this entry focuses primarily on the changing nature of substance addiction. Anthropology has played an important role in unpacking the multiple meanings contained within this phenomenon, tracking its expansion and enmeshment across a diverse range of human domains. The study of addiction encompasses anxieties regarding the changing nature of selfhood, control, and agency, as well as moral and political concerns relating to what counts as ‘proper’ versus ‘deviant’ behaviour. Since the turn of the twentieth century, addiction has increasingly become an object of both biomedical and criminal intervention. This shift has accelerated the birth of a therapeutic-carceral industry, where substance-users occupy the dual role of patient and criminal. This entry traces the development of anthropological thoughts on addiction, demonstrating how cultural approaches to non-Western alcohol use in the 1950s were adopted and expanded as Western social scientists sought more nuanced sociocultural models for understanding substance-use within their own societies. These developments fed into the tradition known as critical medical anthropology, which sought to join experiential accounts of suffering and illness to politico-economic approaches that examined the systemic conditions of inequality. The core contribution of anthropology in the study of addiction has been the generation of rich ethnographic data on the lived experiences and everyday realities of substance-users. This body of work has been instrumental in depathologising the lived world of addiction, demonstrating in vivid colour the complex sociality, cultural values, status dynamics, forms of intimate belonging, embodied experiences, and sociostructural inequities that lie at its heart.

Introduction

As a prism through which to contemplate the contemporary human condition, there are few phenomena that can rival addiction. Indeed, if anthropology is the study (logia) of man (anthrōpos), then addiction is more than a worthy object of investigation. In recent times, the category of addiction itself has expanded to include a far greater range of human endeavours than it has historically encompassed. Activities like sex, technology use, gambling, shopping and eating now sit alongside the more time-honoured activities of drug-taking, drinking and smoking. As Eugene Raikhel (2015) notes, the enlargement of addiction’s rubric to house this greater diversity hinges on the now-pervasive idea that these kinds of activities stimulate our brains in the same way as psychoactive substances do, paving the way for similar forms of self-destructive and compulsive behavioural patterns. Further on, this entry demonstrates some of the ways in which social science approaches to addiction have revealed problems with this brain disease paradigm, in particular the way in which it obfuscates addiction’s psychological, existential, cultural, economic and sociostructural determinants. Whilst this critical discourse applies to the full gambit of supposedly addictive activities outlined above, it is the use of and addiction to psychoactive substances that this entry focuses on, if for no other reason than their sheer ubiquity, contingency, and multiplicity across so many domains of human life.

As both a lived experience and an intellectual concept, substance addiction allows us to investigate diverse concerns such as morality, law, biology, neurochemistry, pharmaceuticalization^[1], agency, free will, and structural violence – to name but a few. And yet, it is also a relatively new object of human interest, grounded in late-nineteenth century Euro-American notions of health, illness, and individuality. As an anthropological concern, it is even newer – not truly capturing the discipline’s attention until the 1960s. Anthropology’s interest in addiction has, in large part, been stoked by major historical transformations in how society has come to understand and regulate the human consumption of psychoactive chemicals.

These transformations include how such chemicals have been culturally and medically conceived. Many contemporary ‘street drugs’, such as cocaine and opiates, for example, were often prescribed during the turn of the twentieth century as over-the-counter treatments for everyday maladies. They also reflect political changes, notably around interconnected themes of race, class, criminality, and power. As rising levels of socioeconomic and racial inequality in the West became tangled up with major public health concerns – such as the HIV/AIDS pandemic – the question of where and why substance-use patterns fitted into these crises became paramount. Addiction thus emerged as a central concept through which to consider the complex intersection between drug-use, therapeutics, epidemiology, and socio-political exclusion.

It quickly became clear that the consumption and circulation of psychoactive substances was no longer reducible to individual failings, be they biological, spiritual, or moral. Instead, social science explorations of addiction have clearly demonstrated the using and sharing of drugs to be intrinsic to local cultural systems, rooted in the social and economic dynamics of a particular place and time. Given that anthropologists have historically defined themselves in relation to the ethnographic study of society and culture, their late-in-the-day study of communities who use and share drugs is somewhat surprising. In point of fact, the now-burgeoning anthropological subfield that began in the 1960s has its roots in the innovative work of several sociologists. Using primarily ethnographic methods, these influential scholars argued not only that substance-use tends to be culturally constructed around local needs and concerns (Dai 1937, Lindesmith 1947), but that the pathologization narratives ascribed to substance-users are as well (Becker 1963). Pathologization refers to the process by which differences in human behaviour, especially those seen as sitting ‘outside’ of conventional moral and cultural norms, are converted into psychological and social aberrations that are seen as inherently destructive, something that increasingly happens through the language of biomedicalization.

Building on these formative ideas, the anthropological study of addiction has grown substantially. It cuts across a number of disciplinary subfields, notably medical, sociocultural, psychological, and political anthropology. Reflecting this boon in interest, a number of different explanatory approaches to addiction have emerged, all couched in their own particular intellectual traditions and scholastic genealogies. In what follows, this entry will first focus on three frameworks surrounding substance-use patterns that have been especially influential: a cultural approach, a subcultural one, and critical medical anthropology.^[2] The latter half of the entry will explore a selection of contemporary approaches to addiction that have emerged from the critical medical tradition. These include the study of differing therapeutic modalities, phenomenological analysis, and the role of temporality in questions of addiction and substance-use.

A cultural approach

Building on the work established by the aforementioned sociologists, the cultural model of substance-use can be traced to Dwight Heath’s (1958) work on alcohol consumption amongst the Camba, a horticultural people living in eastern Bolivia. Heath noted that most of the community’s adults would frequently drink vast quantities of rum during festival periods, sometimes remaining intoxicated for days on end. Rather than being viewed as pathological, though, this collective drunkenness – often to the point of passing out – held an enduring social and spiritual value. It reaffirmed bonds of solidarity as well as sustaining connections to those ancestral spirits who contributed to the health and fertility of the community. Heath’s observations essentially challenged the established orthodoxy that heavy alcohol usage was an intrinsically destructive behaviour. After all, the Camba drank huge quantities of distilled liquor during festive periods – the difference was that their drinking was embedded in a cultural, social, and cosmological context that imbued it with a set of meanings. It emphasised social cohesion over disintegration, collective identity over personal dissolution, and familial connection over breakdown (see also Van Vleet 2011).

In short, their drinking practices did not conform to the pathological model of addiction envisioned through a biomedical lens, in which excessive consumption is seen as intrinsically injurious to both the drinker and their surrounding community. This model, it should be noted, has been subject to a number of dynamic changes as new technologies. In particular neurological imaging techniques and advancements in psychopharmacology have reshaped how Western medicine conceptualises the relationship between behaviour, illness, and biology. The changing shape of biomedicine’s pathologising model, especially its increasing emphasis on the brain as the locus of addiction, continues to hold a profound grip on how substance-use is understood, experienced, and treated. Critically investigating the depth and reach of such pathologising understandings of addiction has become a core concern for anthropologists.

The core contribution of Heath’s cultural model was its capacity to destabilise existing projections of alcohol consumption as pathology. In the process, it shifted analysts’ focus onto emic (‘insider’) constructions of how substances were consumed in a local cultural context. Considering alcoholism to be merely a form of pathology runs the risk of being ethnocentric, that is of projecting one’s own cultural classifications onto the cultural settings of others. According to Arthur Kleinman, this constitutes a ‘category fallacy’. A seminal figure in medical anthropology and cross-cultural psychiatry, Kleinman cautions against the transplanting of Western-based categories to elsewhere places, especially psychiatric diagnoses. Exploring the way depression is expressed and negotiated in China via the moral dynamics of the family rather than the inner life of the individual, Kleinman makes the point that symptom expression is culturally variable, even for illnesses that may have a biological basis (see also Kirmayer & Young 1998). In this regard, Heath’s approach arguably foreshadowed important developments in medical anthropology, in particular the need to question whether Western diagnostic frameworks can be exported across socio-cultural settings, lest the nuances of non-Western lifeworlds thereby be eclipsed.

Heath’s approach, though, was not without its opponents, many of whom argued that anthropology’s tendency to downplay the issues associated with alcohol consumption in non-Western contexts married two of the discipline’s most problematic instincts: romanticization and exoticization (e.g. Room 1984). More broadly, his emic model failed to suitably account for the way in which major changes in the global politico-economic order have transformed and disrupted the shape and rhythm of traditional community life, something that Heath’s field site was certainly not immune from even in the 1950s.

To be fair to Heath, he did in his later work acknowledge how drinking practices amongst the Camba began to shift in relation to the socio-economic and ecological crises they suffered with the growth of the lumber industry in surrounding forests (Heath 1987). Dislocated from its formerly collective ethos, drinking and other forms of substance-use can rapidly become sites of relational breakdown, violence and interpersonal suffering (Quintero 2002). Indeed, anthropologists have observed that problematic forms of substance-use often emerge when social systems suffer major transitions in political organization, kinship, and economy (Frederiksen 2013; Pedersen 2011). The scale of problematic forms of substance-use amongst indigenous groups in the wake of colonial violence is testament to this observation. It reveals the way that historical trauma, dispossession, and social marginalization develop into disruptive drug-taking patterns (Jervis et al. 2003; Musharbash 2007; Spicer 2007; Stevenson 2014). The explosion of drug-related mortalities and other ‘diseases of despair’ throughout the deindustrialised heartlands of the modern West also speaks to the dangers of major socio-structural upheaval and the vacuums that such historical schisms leave behind (Anglin 2002; Billings & Blee 2000; Maggard 1994; Stewart 1996).

A subcultural model

In Heath’s work, heavy alcohol consumption was seen as an integral part of the prevailing moral and cosmological order. It was, in brief, a defining aspect of Camba culture, both as embodied practice and as system of meanings through which to relate to one another. To use the language of Ellen Corin (1995), drinking was central to social life, not peripheral. Over in the Western world, however, heavy forms of intoxication, be it through alcohol or other substances, have not historically been seen as something to be extolled or morally valued. The widespread and heavy-handed criminalization of drugs, the dominance of abstinence-based recovery programmes, and the pathologization of addiction as a psychiatric disorder all gesture to this fact. Accordingly, those who consume these substances are seen as troublesome to the dominant order. They exist on the peripheral edges of cultural norms and values. The drug addict challenges the very logic of Euro-American personhood, in particular the notion that healthy persons are those whose inner lives are stable and autonomous, uncorrupted by the enslavement and chaos of chemical dependency (Summerson Carr 2010). Addicts, then, unfitting of this cultural template, have consistently found themselves relegated to some social space outside of culture, defined primarily through the pathology of their condition.

Historically, these spaces, and the lives of addicts themselves, have been marked by narratives of deviance and exclusion, with little thought given to the complexities and intimacies that pervade them. The ‘subcultural’ thus emerged as an analytical frame through which to attend to them (see Becker 1963). Whilst the ‘sub-’ prefix (literally meaning ‘below’) arguably risks reifying hierarchical divisions of ‘good’ versus ‘bad’ forms of human social life, the purpose of this term was to call to attention the myriad ways that people on the periphery carve out ways of living that are at variance with the prevailing cultural centre. The so-called ‘underworld’ of drug addiction, in other words, is just that – a world; one teaming with complex forms of sociality that cannot be so easily explained away through the dehumanising language of deviance and moral decay.

Again, it was the sociologists who were first to the punch. The subcultural approach to substance-use emerged out of street-based research in America’s inner-cities. Seminal sociological accounts, in their rich descriptions of the selling, buying, sharing, and consumption of drugs, demonstrated these practices to be foundational to the daily lives of vulnerable and marginalised people (see Feldman 1968; Fiddle 1967; Partridge 1973; Sutter 1966). Particularly influential here was the work of Edward Preble and John Casey (1969), who described in intimate detail the social life of lower-class heroin users in New York City. For these users, tracking down and injecting heroin is understood as a ‘career’. It is a never-ending hustle that, from making money to buying the drugs, emerges as a full-time job that imbues each day with meaning, purpose, and business. A major contribution of this body of literature was to challenge entrenched myths surrounding drug consumption, especially intravenous usage, which had historically been viewed with high levels of moral panic. In many countries, notably in the US, the puritanical fear of needles remains ingrained in public health policy, with needle exchange programs regularly defanged or shut down out of the unfounded fear that they abet drug-use (Rhodes et al. 2005).

Unyoking drug-use from its historical associations with illness, social decay, and psychopathology shifted the emphasis of analysts from individual usage to the worlds in which such usage occurred. These worlds are marked by complex survival strategies, such as begging, panhandling, sex work, and petty crime. These strategies encompass sharing economies, rituals of socialization that initiate people into drug-using networks, and underground hustling practices that prop up multibillion-dollar narcotics economies. They include creating concealed urban spaces, such as shooting galleries and squats, that shelter ‘hidden’ populations unconnected to state services, as well as new linguistic forms of ‘street’ slang that are uniquely attuned to the conditions of scarcity, insecurity, and racialised surveillance that constitute everyday urban life in the poorest neighbourhoods. Ultimately, it was the long-term intimacy of the ethnographic method through which researchers could develop enduring relations of trust that provided access to these (under)worlds. The researchers’ emphasis on the emic perspectives, cultural order, and social meaning that were built into the fabric of these worlds serve to depathologise substance-use. Where the subcultural approach to addiction eventually succeeded was in its capacity to illuminate the complex arrangement of values, roles, and status dynamics that structure the daily lives of substance-using communities. What looked to the cultural centre like moral decay, pathology, and escapism, from within the periphery is experienced as meaningful activity. The pursuit, scoring, and taking of drugs serves here as the lifeblood of communal existence (see also Friedman et al. 1986).

Critical medical anthropology

Whilst the subcultural approach did much to enrich understandings of drug-using communities and to counter reductive and simplifying forms of stereotyping, a suspicion lingered that an over-emphasis on the ‘insider perspective’ risked a similar form of romanticising of which scholars such as Heath had been accused. The concern was that it might inadvertently deflect attention from the wider social, historical, and politico-economic forces that shaped patterns of drug-use and addiction. The response to such misgivings was the emergence of a critical medical anthropology in the 1980s, whose analytical goal was to fuse experiential accounts of suffering, illness, and wellbeing with politico-economic approaches that attended to the systemic conditions that drive institutionalised forms of inequality, racialised violence, carceral governance, and social control. The foundational figures of this approach, such as Nancy-Scheper Hughes (1990), Margaret Lock (1987), and Merrill Singer (1989), sought not only to reveal the structures underpinning the social determinants of ill health, but also to apply these critical frameworks in practical ways, collaborating with local communities so as to challenge and ultimately change existing healthcare systems.

A pertinent example of this tradition is the work of Philippe Bourgois (1995, 2009), who has conducted long-term ethnographic fieldwork amongst vulnerable drug-users in New York and San Francisco. Here, addiction is interpreted as a form of social suffering that is inexorably tied to the uneven distribution of wealth and power. In Bourgois’ eyes, America’s neoliberal market economy is rigged in favour of corporate power and special interest groups. Social care services are imbalanced and underfunded, while the principles of individual responsibility and entrepreneurial bootstrapism are still being championed. As a result, an ever-growing number of America’s indigent classes, a disproportionate amount of whom struggle with addiction issues, are turned into a ‘Lumpenproletariat’. This Marxist term historically refers to those people structurally positioned just below the wage worker, who prop up the economic system through irregular employment. In the context of addiction, it describes those vulnerable groups for whom punitive forms of disciplinary governance, such as through surveillance, policing, and incarceration, have become destructive and alienating. This occurs while other segments of the population, notably large corporations, continue to profit from these systems of abuse and punishment. Perhaps the most patent examples of this are the private prison system and the pharmaceutical industry, both of which generate billions of dollars of revenue each year.

The gaping health disparities we see between America’s upper and lower classes not only exacerbate the suffering of vulnerable groups and damage their bodies. They also reshape the bounds of their subjectivity to the point where everyday forms of systemic and intimate violence are experienced as the natural order of things. We see this frequently in cases where substance-users ‘blame themselves’ for the oftentimes brutal and discriminatory situations they find themselves caught up in. Such moments, as Bourgois demonstrates, point us to the way that marginalised people naturalise the structural forces that alienate them by internalising dominant cultural narratives around ideas of personal responsibility. They begin to believe that substance-users must be understood as the sole architects of their own downfall and, by extension, of their recovery as well.

Viewed through this critical lens, substance-use emerges as a form of self-medication through which to attend to chronic conditions of existential distress, powerlessness, and sociostructural alienation. It effectively provides a moment of escapist relief from the painful conditions of the user’s lifeworld. The irony, however, is that using illegal drugs as relief risks attracting exclusionary forms of social control that are likely to compound and amplify that person’s marginalization. Indeed, the ubiquitous forms of policing, punitive surveillance, mass incarceration, and disenfranchisement that underpin the US-led ‘war on drugs’ have turned already-precarious social spaces into what Jarrett Zigon (2019) has termed ‘zones of uninhabitability’. They are places where those who inhabit them suffer chronic conditions of isolation, cruelty, entrapment, and expendability. Since former US President Richard Nixon first declared illegal drugs “public enemy number one” in 1971, this now globalised and highly militarised crusade to eradicate this evil has ultimately become a war on already marginalised people (Zigon 2019). This is a war in which users and nonusers alike are trapped in zones of uninhabitability, made into internal enemies against which the ‘good life’ of the contemporary sociopolitical order can be defined, maintained, and protected.

The war on drugs in the age of the brain

The ongoing ‘war on drugs’ is couched in the notion that people are essentially powerless to resist the temptation that drugs offer. Labelled the ‘exposure’ orientation in clinical circles (Alexander 1982), this notion contends that mere one-time contact with certain drugs (especially opiates) is enough to trigger a self-destructive cycle of compulsive, ever-escalating usage. The addict, in other words, becomes a slave to their substance. This model is the foundation on which the idea of a chronic relapsing brain hinges. It holds that certain drugs ‘hijack’ the reward pathways in the brain – especially those responsible for producing dopamine, the neurotransmitter associated with feelings of pleasure and euphoria, among many other things. The formula ‘dopamine = pleasure’ has been refuted as a gross oversimplification, as the interaction between neurotransmitter production and subjectivity are far more nuanced and complex (Berridge 2007). Nevertheless, the broader paradigm that drugs cause a brain disease has shown itself to be pervasive, underpinning the prevailing idea that drug addiction is rooted in individual biology. In such a view, the addictive substance is seen as mounting a kind of hostile takeover of a person’s brain, in which the neurological mechanisms of reward, desire, and pleasure are systemically compromised.

Much of the empirical groundwork for the exposure orientation stemmed from experiments conducted on rodents in the 1960s. In these experiments, caged rats, who faced the options of drinking either water or an opiate solution, kept returning to the drug-laced bottle, oftentimes fatally. However, in the 1970s, psychologist Bruce Alexander noticed a key structural flaw in the experiments, specifically that the rats were all alone in the cage, with nothing to do but take the drugs on offer. Alexander hypothesised that it was the social isolation, and not the drugs, that sustained their desire to seek chemical relief. To test this hypothesis, he built ‘Rat Park’ – a sort of rodent utopia in which the rats had plenty of space to eat, run, and, most importantly, socialise. Despite facing the same two options, the rats hardly ever touched the drug-laced water, and none of them ever came close to overdosing. From this study and several variations, Alexander developed the ‘adaptive orientation’ view. It holds that addiction ‘is an attempt to adapt to chronic distress of any sort through habitual use’ (1982: 367). In other words, it is not the chemical that causes addiction, but the cages in which beings find themselves.

The extension of this idea is that a human being’s everyday reality can be experienced as cage-like. This chimes with broader anthropological investigations into the ways in which the uneven distribution of wealth, power, and resources has created conditions of extreme social isolation, chronic scarcity, and endemic precarity. These conditions are compounded through the exclusionary policies championed by drug war ideologues. Self-medication through drugs thus emerges as one of the few adaptive coping mechanisms available to deal with these cage-like conditions. This is because psychoactive drugs serve as a readymade shortcut to induce in the user alternative states of being. They may be brief and potentially costly, but they transport the user beyond the existential crises that are otherwise engulfing them.

Chemical interventions

The notion that psychoactive chemicals can act as transformational catalysts within broader healing rites has been noted across history and culture. In particular, hallucinogenic botanicals (such as ayahuasca, peyote, or iboga) have been used in ritual contexts in many small-scale societies to open up pathways between the human and the spirit world (Dobkin de Rios 1972). Taken in a collective setting and guided by ritual specialists such as shamans or other spiritual leaders, these substances open up new therapeutic pathways by reconfiguring the complex relation between self, ego, personhood, culture, and cosmology (Grob & Dobkin de Rios 1994). In the West, however, these institutionalised forms of ritual healing have been largely dismantled and disavowed over the course of modernity along with the stewards who sustain them. They have been replaced by an individualised, highly biologised therapeutic model that hinges on biomedical understandings of illness and disease (Kleinman 1988; Napier 1992, 2004). The modern pharmaceutical industry has emerged in lockstep with these historical changes, locating illness primarily in individual bodies and, in the case of mental health and addiction issues, the brain (see Raikhel 2015).

Whilst Western healthcare systems and certain ritual formats both incorporate chemical interventions into their modes of healing, there are crucial differences in how these substances are implemented, experienced, and conceptualised. For example, the Navajo, an indigenous people of the Southwestern United States, have long employed peyote in their healing ceremonies. Native to Navajo land, peyote is a small cactus plant that contains a hallucinogenic compound known as mescaline, which can profoundly alter a person’s sense of self and reality. According to anthropologist Joseph Calabrese, who took part in these rituals, peyote can be understood as a technology of consciousness modification that allows the sufferer to situate themselves in a broader arc of symbolic and spiritual healing. In other words, the visions, sensations, insights, interpretive activity, and encounters produced within what are known as Peyote Meetings are part of a deeper cultural narrative that reflects and responds to the Navajo cosmos. It is part of a universe that includes not just other humans but also non-human spirits, animals, and ancestors. For Navajo struggling with illness such as alcoholism or depression, taking peyote in ritual contexts opens up lines of communication with omniscient spiritual beings. Direct engagement^[3]with these spiritual entities can aid in the recovery process by providing deep personal insights that would otherwise remain hidden (Aberle 1991; Calabrese 2008).

As a collective cultural experience, the ceremonial distribution and ingestion of peyote differs radically from the clinical prescription of modern pharmaceuticals. In the latter context, the patient’s illness is located primarily in the brain’s faulty or damaged circuitry, while social and existential conditions are rendered peripheral to diagnosis and treatment. As psychiatry has become increasingly biologised (Luhrmann 2001), the result is that more and more mental health conditions are being designated as chronic (i.e. without end). Consequently, these afflictions require constant maintenance through on-going prescriptions and daily pharmaceutical intervention that operates on a molecular level.

Pharmakon dualities

We can learn more about the pharmaceutical approach to addiction by looking at the premise of opioid substitution therapy (OST) for those who are struggling with opioid dependency. OST is practiced in clinical settings across the globe. In it, the patient is prescribed a synthetic opioid such as methadone or buprenorphine that mimics the biochemistry of other opioids whilst suppressing euphoric sensations. By substituting one drug for the other, OST is designed to wean the addict off from the opioid they are perceived to be ‘abusing’, reducing cravings whilst staving off the physical and psychological symptoms of withdrawal. This idea of replacing ‘bad drugs’ with so-called ‘good medicines’ has been analysed as a site of profound contradiction by anthropologists. One prism through which a number of them have explored this idea is through the notion of the pharmakon – pharmacology’s etymological root, from the Greek. Pharmakon is a term used to describe things that hold a double valence as both cure and poison, something that has indivisibly positive and negative effects. Pharmaceutical opioids used in OST oscillate between the licit and the illicit (Bourgois 2000; Garriott 2011; Lyons 2014). They are thus an archetypal modern example of pharmakon, pendulating between being miracle cures and deadly poisons (see Biehl 2005; Meyers 2014).

Substances that carry these dual identities can radically blur the partition lines between therapeutic use and abuse. This has been shown by the unprecedented surge in morbidity and mortality associated with opioid pain relievers that has swept the United States in recent years. Aggressively marketed ‘miracle’ painkillers, such as the now-infamous Oxycontin, have flooded the US healthcare system. Their curative capacities soon turned poisonous as they took root within already-precarious communities which had been progressively compromised through the ‘perfect storm’ combination of deindustrialization, socioeconomic neglect, social safety net cuts, and mass unemployment (Dasgupta et al. 2018). Ironically, using OST as the predominant clinical response to the opioid crisis hinges on the same therapeutic logic that led to the proliferation of drugs like Oxycontin in the first place – namely that pain is a biological disorder (see Crowley-Matoka & True 2012). Addiction is here reduced to a set of individual withdrawal symptoms that emerge in relation to the internal dynamics of certain neurochemical pathways. It thus becomes unyoked from its social, political, and existential conditions. In America’s case, the conditions for the proliferation of opioid pain relievers were especially ripe. Pain relievers spread as part of an entrenched culture of pharmaceuticalization (Oldani 2014) that has been amplified by gaping disparities in health and wealth across the population, a rapacious health-care sector with huge barriers to treatment for those who cannot afford it, as well as a lack of unemployment support combined with an emphasis on the importance of maintaining work despite illness or injury.

Addiction, phenomenology and the temporal turn

To move beyond ‘neurocentric’ accounts and understand how wider structural conditions shape addiction, a number of scholars who identify with critical medical anthropology have turned to the philosophical field of phenomenology for inspiration. Simply put, phenomenology can be understood as a philosophical method that seeks to reveal the structure and conditions of lived experience by articulating how the world appears and is felt from an embodied perspective (see, for example, Good 1994; Csordas 1994; Throop 2007). Broadly speaking, then, phenomenological accounts consider a larger range of experiences than simply that of suffering and pathological compulsion. They describe the complex ways that pain intersects with pleasure, despair with hope, and creativity with destruction. At the same time, they hold that such complex forms of subjectivity are always already embedded in particular social, political, historical, and conceptual contexts (Mattingly 2019; Zigon 2018). For a number of scholars working in this subfield, much of the analytical emphasis has been on the way that substances are used as a means to alter temporality – the lived experience of time – under conditions of precarity.

This analytic move reflects broader discussions within the phenomenology of drugs that focus on their capacity to radically alter the subjective experience of time (Cope 2003; Deleuze 2004; Denzin 1987; Flaherty 1999; Hill 1978; Huxley 2004; Lapp et al. 1994; Klingemann 2000; Reith 1999; Shanon 2001; Smart 1968). For example, in her seminal work amongst Hispano heroin-users in New Mexico, Angela Garcia (2010) engages with melancholia, or endless mourning, as a way to articulate the historical dimensions of addiction and drug treatment in the region. For Garcia’s interlocutors, heroin use and the intimate losses it inflicts upon communities through incarceration and overdose deaths is experienced as indivisible from the long history of agricultural land dispossession, grinding rural poverty, and social abandonment. Addiction expresses loss and mourning for a past and a cultural identity that struggles for coherency in the face of widespread socioeconomic change. People here live in a purgatorial world where historical suffering meets clinical therapeutics and where each repeated descent into heroin usage fortifies the prevailing model of addiction as a chronic, ‘no exit’ disease.

My own work amongst London’s inner-city homeless has also engaged themes of temporality. It describes how rough sleepers use anaesthetic intoxicants such as alcohol, opiates, and pharmaceutical sedatives to induce blackout states. These provide a temporary reprieve from the chronic existential crises, painful memories, and deep boredom that undergird street living (Burraway 2018). Many of the homeless describe these blackout states in terms of ‘becoming somebody else’. Thereby, they experience the blackout as a paradoxical form of self-healing. It refashions the normal interface between self, memory, agency, body, and world. The blackout is paradoxical because it transports the homeless into a memoryless state where they are no longer burdened by the crisis of their own presence. Yet it also evaporates the moment the drugs wear off. In this regard, the blackout traps them in a Sisyphean loop in which the very experience of escape is forever held just out of conscious reach.

Approaching drug-use by focusing on how it alters people’s relationship to time has turned out to be a fruitful mode of inquiry, especially in social contexts marked by scarcity, precarity, and vulnerability. For example, in their ethnography of khat consumption among Ethiopian unemployed youth, Mains et al. (2013) note how finding the stimulant khat and then chewing it with others imbued the day with some kind of meaningful rhythm, in the process taking up time, of which there was plenty. So, rather than using psychoactive substances to annihilate the threat of an empty future by inducing anaesthesia – as was the case for my homeless interlocutors – these young Ethiopian men used khat’s stimulant properties to move towards an alternative vision of the future. They sought the psychoactive condition of mirqana, a state which moved them beyond the banal realities of the present and into dreams and hopes for a better time to come. Aligned with these studies is a large body of literature on the concept of waiting, which explores the various ‘time-killing’ strategies that people use to cope with economic stagnation, chronic joblessness, and deep boredom (Masquelier 2013; Harms 2013; Ralph 2008; Honwana 2012).

These studies also foreground that the body becomes central during periods of crisis. When the world feels as though it is spinning out of control, it is the body – people's foremost technical instrument (Mauss 1979) – that often becomes the new locus of control and transformation, a last resort of control in an otherwise-unmanageable world. This has been shown in ethnographic studies on topics as varied as homelessness (Bourgois & Schonberg 2009; Desjarlais 1997), eating disorders (Lester 2009), organ trafficking (Scheper-Hughes 2001), and prostitution (Day 2007; O’Neil 2015). The sad irony, however, as some have argued, is that the ‘resort’ to individual bodily techniques in times of crisis, such as through heavy drug-use, often ends up reproducing the very politico-ideological demands that the person in question seeks escape from. The imperative to take ‘personal responsibility’ for one’s own self-transformation has a decidedly neoliberal edge to it insofar as the locus of transformation is rooted in autonomous decision making rather than any kind of meaningful changes to the individual’s social and existential conditions.

Conclusion

The study of addiction is a messy and highly disjointed research field, described by some in terms of ‘conceptual chaos’ (Shaffer 1997). Much of this chaos can be seen as reflecting broader historical transformations in how Euro-American cultures have come to think about the human condition. Addiction has developed from being considered a spiritual affliction, conceived through Christian theology, to its present incarnation as a brain disease. Its study demonstrates the extent to which contemporary understandings reflect changing ideologies about the core elements of personhood, agency, and subjectivity. This path, though, is neither singular nor linear.

Anthropology has done much to parse out the complexity of addiction, which moulds and is moulded by the contexts in which it emerges (Raikhel & Garriott 2013). The discipline’s cross-cultural perspectives that allow for a more diverse body of thought on the topic challenge the hegemony enjoyed by neuroscientific approaches. While neuroscientific approaches do have merit, their virtues should not be extolled at the expense of alternative perspectives that may also be correct. It is for this reason that some scholars urge us to embrace analytic and interpretive multiplicity. They argue that a ‘vibrant epistemic pluralism’ (Raikhel 2015: 391) will provide a far richer and more nuanced conceptual vocabulary through which to make sense of addiction. Ethnography, which embraces human complexity at both the individual and structural level, has allowed anthropology to come up with many important insights since, its relatively late arrival to the addiction conversation. It has done this primarily by placing emic concerns and lived experience at the forefront of analysis. Ethnographic work emphasises the role of cultural mechanisms in shaping ideologies and experiences surrounding substances-use. It depathologises the social life of addiction amongst marginalised communities and problematises state institutions that effectively fuse therapeutic domains with criminal ones. Further, by moving the analytic lens beyond the individual user, anthropology has illustrated in granular detail that addiction cannot be uncoupled from history, policy, inequality, and political economy.

Addiction has also become a fundamental site for the production of theory, as it sits at the intersection of so many aspects of the human condition, which often stand in contradiction to one another. Thus, addiction is simultaneously an aspect of lived experience and an object of biomedical knowledge, a condition of therapeutic possibility as well as of penal coercion. It is a world of ecstatic pleasure and of debilitating pain, an escape route as well as a prison. Caught up in the swirls and eddies of this ambivalent churn are those who live with addiction each day, their on-going relationships with their chosen substances forcing us to rethink the boundaries of human agency. Above all, they highlight the need to avoid reductive accounts and to hold within our analytic frameworks multiple perspectives at once. To understand addiction, we must consider the structural in tandem with the experiential, the personal with the political, and the epistemic with the existential.

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Note on contributor

Joshua Burraway is a cultural medical anthropologist whose research interests sit at the intersection between social and political theory, critical phenomenology, addiction medicine, and psychiatry. His research interests emerged from a long-term ethnographic study of homeless substance-users in inner-city London. Currently, he is carrying out research in rural Appalachia exploring deindustrialization, social trust, and the proliferation of opioids and other narcotics, such as methamphetamine.

[1] Broadly speaking, pharmaceuticalization refers to the reconfiguring of human realities, processes, and capabilities into opportunities for pharmaceutical intervention, augmentation, or enhancement.

[2] See Singer (2012) for a more exhaustive historical literature review of these approaches and several others.

[3] See also Scherz & Mpanga’s (2019) work in Uganda for how direct spiritual intervention can facilitate recovery from alcoholism.