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Nobody is normal: "The line between healthy and not healthy is drawn more by culture than by nature”

Who is crazy? Who is normal? Describing somebody as "not normal" has serious implications for this person, can destroy her life. From an anthropological perspective, there is nothing called normal. What we have are endless ways to lead a more or less meaningful life. Principally, everybody is as crazy as everybody else. The distinction in normal or crazy is artifical – it has to do with culture, history and politics, and is therefore an interesting object of study.

In this sense, anthropologist Roy Richard Grinker has written an important book that was just released: Nobody’s Normal: How Culture Created the Stigma of Mental Illness.

In this book he explores the roots of mental illness stigma around the world – and reveals how our prejudices and notions of mental illnesses and ‘normality’ reek of cultural biases that stop many from seeking help.

According to a very interesting review by Claudia Wallis in Spectrum News, Grinker shares Sigmund Freud’s wish that mental illnesses would be viewed “like the common cold, something everyone gets from time to time,” and that people “might eventually feel no shame in seeking psychological care for their problems.”

So why do people in the so-called West, and increasingly everywhere else as well view mental illnesses differently? And where does the stigma come from?

Grinker traces the stigma back to industrial revolution and capitalism in in late 17th-century Europe, Claudia Wallis writes:

>With industrialization, people with intellectual disabilities, schizophrenia and other serious brain conditions were moved out of their homes and into asylums, along with criminals, debtors and addicts — basically anyone viewed as incapable of being a productive and self-sufficient worker.

> Once institutionalized, people were sorted by their caretakers into categories: “idiotic” and “insane,” “probably curable” and “probably incurable,” and eventually more specific, medicalized terms. The words “normal” and “abnormal” were borrowed from mathematics and statistical averages.

> As new categories of sickness and perceived deviance were added — mania, melancholia, dementia, masturbation (an actual diagnosis!) — the number of people consigned to asylums exploded in England and the United States. “Experts were at a loss to explain the apparent epidemic created by illnesses they themselves had invented and were now counting,” Grinker wryly observes.

In an interview with Psychology Today Grinker provides more details:

> When capitalism took hold, we started to value individual autonomy and productivity for everybody. Before that, we didn’t hold a person responsible for all of their differences and all of their successes and failures

> In the U.S., the hero is the individual. People with disabilities aren’t necessarily always able to be independent. By the very nature of capitalism, the person who depends on others, who lives with others, or who isn’t an efficient worker is considered to be a failure.

As a contrast he provides an example from rural Namibia:

> A man I’ll call Tamzo, who lives in rural Namibia, has what we would call schizophrenia. He walks 20 kilometers to the village once a month to get antipsychotic medicine. The Western doctor there writes down his diagnosis as schizophrenia.

> But at home he is thought to be the victim of a curse that somebody placed on their village that settled randomly on Tamzo. In his family and his village, as long as he is not hearing voices, he’s not considered at all to be sick. Whereas in the clinic, it’s “once labeled, always labeled.”

The anthropologist does not deny the existence of mental illnessess, Virginia Hughes writes in her review in the New York Times. But for the past few centuries, Western doctors have been fixated on distinguishing normal from abnormal. And those bright demarcations have made it easier to stigmatize people.

Grinker does not believe that a focus on the precise genes and biological mechanisms behind brain conditions such as autism and schizophrenia will reduce stigma. Neuroscientists hoped this would make mental illness more equivalent to for example heart disease:

> Grinker disagrees. He notes that in some parts of the world a genetic basis becomes even more stigmatizing, as it casts doubt on bloodlines. And he believes that mental illness can never be entirely reduced to biology. As with hypertension, osteoporosis, hypercholesterolemia, obesity and many other conditions, the line between healthy and not healthy is constructed, or, as he puts it, “drawn more by culture than by nature.”

>> review in Spectrum News

>> review in New York Times

>> interview in Psychology Today

Check also his website, his texts in Psychology Today with titles as The Racist Origins of the Modern Concept of "Schizophrenia" and his Ted Talk:

Reading about his book, I remember a useful concept that the Norwegian researcher Ivar Morken introduced – in Norwegian he called it "normalitetssentrisme" – in English it might be normalcentrism. He thinks it would be fruitful to talk about nornalcentrism in a similar way as we talk about ethnocentrism.

Mental illness and normalcentrism has been topic before, therefore:

SEE ALSO:

The globalisation of the Western conception of mental illness

Ethnography about Deaf People: It is insufficient to understand deaf people as disabled. Most deaf people are proud of their culture

Medicine as power: "Creates new categories of sick people"

Why anthropologists should politicize mental illnesses

The Anthropology of Suicide

Who is crazy? Who is normal? Describing somebody as "not normal" has serious implications for this person, can destroy her life. From an anthropological perspective, there is nothing called normal. What we have are endless ways to lead…

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Corona-Anthropology: We feel safe with "people we know", for the danger always comes from "the others"

Do you wear a mask when you meet your friends? Do you?

Recently I often had to think of an observation of a Twitter user in Germany: She or he realised that people do wear masks in public transport or in supermarkets but showed careless behaviour when they are with people they know: They rarely wear a mask when they are with friends or with colleagues at work.

Today I’ve stumbled upon anthropological research that conforms this observation: In her short article Staying safe in the time of coronavirus: pay attention to ‘the guy you know’ medical anthropologist Lisa J. Hardy writes about her ongoing research on how people in the US experience living during a global pandemic. She and her team bserved the same tendency: People feel safe with people they know, but are scared of people they define as "others", although people know that "viruses do not travel along lines of familiarity". Our behaviour is far from logical:

> What we are seeing in our data from this project has a twist on the idea of “other.” People are telling themselves stories about the safety of people they know. This means that many people report that they’re doing everything possible to stay safe and, in the next breath, tell us about a party they attended for the holidays with friends and family. “It’s OK,” they say, “we knew everyone there.”

The danger, we tend to think, always comes from "the others".

>Some interviewees in the Southwest told us that they avoid shopping where Indigenous people go because of high rates of Covid-19 on reservations, indicating the kind of racism and avoidance that often comes with contagious disease.

These "sometimes illogical conclusions about other people" are " not unexpected", she writes:

> Throughout history there have been examples of epidemics and blame. Someone else is often considered to be the vector of disease.

>> read the whole article in StatNews

In her article she also links to a paper she published in the journal Medical Anthropology last September called Connection, Contagion, and COVID-19 where she in the abstract stresses the importance of social science research when dealing with Covid-19:

>In the United States people understand the global pandemic not as biology, but as the manifestation of political affiliation, difference, connection, and disconnection. COVID-19 is, according to public perception, dangerous because it maliciously mutates to attack. It is “a guy we don’t know.” Relationships between the mysteriousness of the virus and heightened visibility of longstanding inequality in the United States form new contexts for existing social tensions. (…)

> Here I draw on analysis of 50 semi-structured interviews we conducted from March to August of 2020 demonstrating how understandings of the biology of a virus are woven into perceptions of politics, inequality, and the fractures of a divided nation. To understand social and political responses to the global pandemic it is essential that we continue to investigate xenophobia, inequality, and racism alongside the biological impact of SARS-CoV-2.

She also has a nice website with many articles, including creative writing, check www.ljhardy.com

There has already been conducted extremly much anthropological research on Covid-19 / Corona, I have lost the overview, so, for the time being, I just refer to The Anthropology Newspaper on Covid-19 and the coronavirus and also on open access journal articles in The Anthropology Journal Ticker on Covid-19

Do you wear a mask when you meet your friends? Do you?

Recently I often had to think of an observation of a Twitter user in Germany: She or he realised that people do wear masks in public transport or in…

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The global trade with poor people’s kidneys – Interview with Nancy Scheper-Hughes Part 2/3

By Aleksandra Bartoszko. Oslo University Hospital, Equality and Diversity Unit


Scars after removal of a kidney. Photo: bee free patrrizia grandicelli, flickr

See part I of the interview Being radical critical without being leftist and part 3: Writing an anthropological detective story

Spring 2011 I attended seminar “Engaging medicine” at the University of Oslo in honor of one of the most prominent medical anthropologists in Norway – Benedicte Ingstad. One of the speakers was Nancy Scheper-Hughes with a paper “Medical Migrations – From Pilgrimage and Medical Tourism to Transplant Trafficking».

Scheper-Hughes is professor of anthropology and director of the program in Critical Studies in Medicine, Science, and the Body at the University of California at Berkeley. She is known for her research on structural and political violence, anthropology of body, illness, suffering, maternity and poverty. Her most famous publications are monographs Saints, Scholars and Schizophrenics: Mental Illness in Rural Ireland and Death without Weeping: the Violence of Everyday Life in Brazil.

Since I got engaged in medical and critical anthropology, Scheper-Hughes has been to me a constant source of inspiration and provocation. As an anthropologist who supports and has been doing public and applied anthropology she co-founded Organs Watch, a medical human rights project focusing on organ trafficking. In more than ten years she has been working on the global organ trade. Following the illegal flow of kidneys, she has mapped the tragic network of rich buyers and poor sellers all over the world.

I always wondered how her adventure with kidneys started. She answers:

– It was a very different kind of a project and it was not one that I ever could have imagined spending so much time on.

– I wrote an article that emerged from chapter 6 of my book “Death without weeping” where I write about bodies in dangers, the dead body and favela residents’ fears and their feelings of ontological security or insecurity of the body. And I was studying the emergence of local death squads that were operating after the end of the military period, taking the place of the militarized state. I found that there was real medical mistreatment of poor bodies in clinics, in forensic institutes, and in the graveyard. And above all of this was hovering a terror that people had that their bodies would be used for organs. So I wrote some articles trying to explain why people thought they would be subject to kidnapping for the purpose of organ theft.

– At the time I still thought that this was mainly an urban legend. But then underneath the legend were these real experiences that poor people encountered in forensic medical institutes or police morgues where the unidentified, unclaimed body was, in fact, state property, and (to be crude) chopped up and harvested. So the people were right in fearing that their bodies were not safe.

By Aleksandra Bartoszko. Oslo University Hospital, Equality and Diversity Unit

Scars after removal of a kidney. Photo: bee free patrrizia grandicelli, flickr

See part I of the interview Being radical critical without being leftist and part 3: Writing an anthropological detective story

Spring…

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Deadly migration: The ignored health crisis on the US-Mexican border

A multi-dimensional public health crisis is unfolding on the U.S.-Mexico border that few seem ready to acknowledge, anthropologists Rachel Stonecipher & Sarah Willen write on the Access Denied blog.

The complexity of this crisis came to light during a recent study tour to Tucson, Arizona, in which Rachel Stonecipher took part.

Dehydration and heat-related illness claim hundreds of lives annually, and many of these deaths go unrecorded. No uniform system exists to count or repatriate remains. “We can only imagine the impact of these missed opportunities for identification on family members searching for their loved ones”, Stonecipher and Willen write.

For migrants who do reach their destination but face subsequent arrest, “interception” itself can involve serious health risks:

What happens to migrants after they are arrested and detained often remains shrouded from both the public eye and, to a great extent, the eyes of the human rights community. This is a particularly grave concern when arrested individuals already are sick or injured. (…) One especially serious concern involves the deportation of injured individuals who have not yet been medically stabilized. (…)

Detainees are also at risk of abuse – physical and mental – at the hands of police and Border Patrol officers. Despite official denials, No More Deaths, the Border Action Network, and other NGOs have collected and responded to numerous reports of abuse.

Through water stations, humanitarian aid camps, and desert patrols, a handful of NGOs provide assistance to migrants in need. But this cross-border health crisis is “far too vast for activists to address alone”, the anthropologists note:

Both human rights principles and contemporary realities demand that we hold countries with porous borders – including but not only the U.S. – accountable. Not only must such countries recognize migration as an enduring global phenomenon with complex causes and share accountability for both lives and deaths, but they must also engage in transnational public health efforts to develop the kind of multi-layered interventions needed to protect human life in border regions. (…)

Like the humanitarian organizations that work along the border, we all must insist on an expansive understanding of “public health” that recognizes people in transit as members of a common moral community: as people who are connected to us, and whose lives matter. Whether or not we understand or agree with the choice to migrate, activists along the U.S.-Mexico border remind us that border crossers are human beings who – like all other members of our moral community – are deserving of health-related attention, investment, and care.

>> read the whole post at Access Denied

SEE ALSO:

The “illegal” anthropologist: Shahram Khosravi’s Auto-Ethnography of Borders

“Human smugglers fight global apartheid”

No more conferences in Arizona: Anthropologists condemn Immigration Law

Why borders don’t help – An engaged anthropology of the US-Mexican border

Online: On the Margins – An Ethnography from the US-Mexican Border

Migration: Paperless underclass exposes dark side of Europe

“Ethnographic perspectives needed in discussion on public health care system”

A multi-dimensional public health crisis is unfolding on the U.S.-Mexico border that few seem ready to acknowledge, anthropologists Rachel Stonecipher & Sarah Willen write on the Access Denied blog.

The complexity of this crisis came to light during a recent study…

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“Difficult to read, chaotic, bothering conclusions”

Russia has one of the fastest-growing rates of HIV infection in the world, and the Church remains its only resource for fighting these diseases.

Antropologi.info contributor Aleksandra Bartoszko reviews Jarret Zigon’s recent book „HIV Is God’s Blessing”. Zigon takes the reader into a Church-run treatment center near St. Petersburg that employs both priests and psychologists to work with the HIV-infected drug users.


Review: HIV Is God’s Blessing. Rehabilitating Morality in Neoliberal Russia by Jarret Zigon, University of California Press, Berkley, 2011

Aleksandra Bartoszko, Oslo University Hospital

Russia has one of the fastest-growing rates of HIV infection in the world, and the Church remains its only resource for fighting these diseases.

Antropologi.info contributor Aleksandra Bartoszko reviews Jarret Zigon’s recent book „HIV Is God’s Blessing”. Zigon takes the…

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