Medizinethnologie

Where is my mind? Ecologies of healing and care in more-than-human worlds

Max Schnepf and Karoline Buchner

With your feet on the air and your head on the ground

Try this trick and spin it, yeah

Your head will collapse

But there’s nothing in it

And you’ll ask yourself

Where is my mind? Where is my mind? Where is my mind?

Pixies – “Where is my mind?”

Dead olive trees in the countryside of Ugento, in Salento. Entire swathes of the region now look like an eerie cemetery of desiccated trees, some of which had stood for centuries if not thousands of years. (Photo with permission by János Chialá 2017)

In his writing at the intersection of anthropology, psychiatry and human-environment relations, the location of the mind was a major concern for Gregory Bateson. Not unlike the Pixies, he argued that the mind is not to be found in a person’s head. Bateson’s “ecology of mind” does not engage with an individual mind, either located in or, in the case of the Pixies song, forcefully evicted from an individual body. The “larger Mind”, Bateson argues, drawing on cybernetics, is “immanent in the total interconnected social system and planetary ecology” (Bateson 1978: 461).

With their feet placed firmly on the vinyl floor of the Freie Universität (FU) Berlin and their heads in anthropological theory and ethnographic materials, about 40 anthropologists gathered from May 16 to 17, 2019 to participate in a workshop, organized by the Working Group Medical Anthropology within the German Anthropological Association (DGSKA). “Exploring Ecologies of Mind in (Mental) Health: Eco-Pathologies and Onto-Politics of Healing Economies” – with this (admittedly quite buzzwordy) workshop title, the organizers, Caroline Meier zu Biesen, Nasima Selim (both FU Berlin), Claudia Lang (Cermes3, Paris) and Dominik Mattes (FU Berlin) asked the participants to rethink their ethnographic materials by taking Bateson’s work as a point of departure and creative tool.[1]

In a similarly open manner, the call for papers asked for an engagement with recent developments in “ontological anthropology”, Anthropocene thinking and multi-species ethnographies with their focus on relations between humans and their non-human companions (Kirksey and Helmreich 2010, Kohn 2015). For the study of traditional medicine, mental health and ecologies of healing/care, these new approaches in anthropology and beyond should facilitate more experimental explorations of the “mutual co-constitution of actors and entities that are otherwise considered discrete and bounded elements of the social world”, as the CfP states. The presentations engaged with this strand of thinking to question long-established dichotomies between, for example, body and mind, nature and culture, or tradition and modernity through regionally and thematically diverse case studies from Asia (Bhutan, Sri Lanka, India, Turkey), Africa (Morocco, Ethiopia, Uganda, Tanzania), Polynesia (Tonga), South America (Bolivia, Peru), and Europe (Italy, Netherlands, Germany).

The 15 presenters were organized into three panels: “Landscapes and human-environment relations” (chaired by Mustafa Abdalla), “Traditional medicine and spiritual healing in more-than-human-worlds” (chaired by Caroline Meier zu Biesen), and a two-part panel on “Ecologies of mental health care” (chaired by Angelika Wolf and Britta Rutert, respectively). Beyond these thematic groupings, however, the presentations were struggling against smooth categorizations as they varied in scale, region and focus. We found the talks to be partially connected across panels – sometimes bearing striking resemblances even. To point out the manifold interfaces – forming an ecology, so to speak – without obliterating the frictions between the presentations (De la Cadena et al. 2015: 438), we organize them in five thematic clusters in which some papers appear more than once.

Healing ontologies in health care institutions

Several papers shared their interest in institutional collaborations as well as ontological clashes between different healing systems. Müge Akpinar (FU Berlin) presented insights from her research about an Istanbul-based healing movement which combines different healing traditions to reconceptualize Islamic medicine. She argued that since traditional therapies have been legalized and institutionalized in 2014, they have introduced more holistic views on the mutual constitution of body, health and ecology into the Turkish biomedical health system. Rebecca-Rosea Blome (FU Berlin) investigated a Peruvian NGO’s use of Amazonian medicinal knowledge to treat mental health patients, mainly with substance addictions. By cooperating with indigenous groups to produce plant-based medication and to gain official recognition for Amazonian medicine, the NGO deploys what Blome called “epistemological practices of reciprocity” as they mediate between spiritual and biomedical worlds as well as between indigenous groups and the Peruvian nation-state. Claudia Lang (Cermes3, Paris) also discussed institutionalized collaborations in her exploration of Ayurvedic psychiatry in Kerala, India, which treats depression as a “physio-moral problem”. Like Akpinar and Blome, she highlighted how non-Western cosmologies present an ecological approach to (mental) health in themselves as they defy a mind-body-environment distinction. At the same time traditional medical practitioners engage with global health discourses inciting processes of translation but also reinforcing epistemic differences in which tradition is (re)invented and used as an economic and political resource. Processes of translation were also central in Mike Poltorak’s (University of Kent) presentation about the ecology of spirits in Tonga. In his filmic engagement with a spiritual healer, her clients, and a psychiatrist, he pointed out attempts at translating between two seemingly incommensurable healing systems. Lastly, Márcio Da Cunha Vilar (University of Sussex) presented new approaches in the medical sciences themselves that question and extend institutionalized ontologies of mental health. Discussing the case of Internal Family System Therapy as a therapeutic approach to rheumatoid arthritis and depression, Da Cunha Vilar showed that evidence-based medicine incorporates the notion of “multiplicities of self”, destabilizing the mind as a monolithic entity.

(Un)speaking bodies and minds

Three papers engaged with language and its movement between and connection to minds, bodies and (local) environments in very different ways. In his person-centered ethnography, Tyler Zoanni (University of Bayreuth) examined how the capacity to use language as self-expression functions as a marker for the distribution of difference in Uganda, serving as a basis for labeling people as cognitively or intellectually disabled. This ecology of mind that privileges “rhetorical virtue” as its index categorizes people with cerebral palsy, autism and down syndrome differently from their counterparts in the US or Europe. Similarly interested in the translatability of representation, Florin Cristea (FU Berlin) asked why, in the context of mental health care in Tanga, Tanzania, certain representations “stick” and not others. A concept of the mind as cognition, framed in psychiatric terms of body and mind by healthcare professionals, is not communicated and transferred to patients, who often see social relations as background for illness. The reason for the non-transmission of the biomedical concept of mind, Cristea argued, lies in the desire to preserve uncertainty and hope for the future in the face of illness. In her project based in artistic research, Ulrike Scholtes (University of Amsterdam) investigates and employs mindfulness exercises to question the mind-body dichotomy and the juxtaposition of words and feelings. During a participatory session, Scholtes illustrated that the spoken words of mindfulness practitioners enact the mind-in-a-body with a “feeler” who is invited to feel or even told how to feel with a body that is attended to through different techniques.

Haunted landscapes and ecological healing

The next group of papers engaged with landscapes that are haunted, both materially and symbolically, by diverse actors and factors ranging from history and environmental destruction to bacteria and chemical weapons. How are health and sickness entangled with landscapes? And how does healing occur in conversation with as well as at the cost of the environment? Young Su Park (FU Berlin) presented the case of an Ethiopian landscape haunted by the trauma of the Oromo people, materialized in the Oda tree’s historic role as the site of the 1886 massacres. Tying together the histories of forced resettlement and mandatory conscription during the Ethiopian socialist regime, Park showed that the Oromo people’s use of the Oda tree as a traditional spot for meetings transforms it into a site of memory and healing where alternative political futures are imagined. Federico Reginato (University of Turin) discussed historically and politically produced “cancer landscapes” in Morocco’s Rif region. The colonial use of mustard gas, land poisoning and recent economic misery have produced cancer as a “historical language” through which the inhabitants relate to and express economic, historic and political hardship. Enrico Milazzo (University of Turin) brought into conversation the bacteria-caused dying of olive trees in South-East Italy with his main interlocutor’s intestinal disease, framing the destructed soil of the olive trees as an “open air intestine”. By producing olive oil in a traditional way “with the right time” and attributing healing capacities to his oil, Milazzo’s interlocutor positions himself against modern modes of production with their destructive effects on environmental and personal well-being. In a similar vein, Claudia Lang pointed out the environmental stress of mass plantation of Ayurvedic medicinal plants for a global market, thereby hinting at the relationship between traditional medicine and environmental exploitation under global capitalism.

Institutional and urban ecologies of care

Another set of papers dealt with the distribution of mental health care among networks of heterogeneous actors. They show how care is practiced within and also against its institutional settings, often in unexpected ways. Nadia Augustyniak (University of New York) examined idiosyncratic practices and discourses of care among psychological counselors and their clients in centralized governmental institutions in Sri Lanka. Although trained in frameworks influenced by positive psychology, the counselors nevertheless frequently overcome these depoliticizing, medicalizing and individualizing narratives to address their clients’ often systemic “ecologies of distress” and provide aid to the best of their abilities in what Augustyniak called “acts of kindness.” Care takes on an unexpected form in Florin Cristea’s paper as well: Health professionals in a psychiatric hospital do not engage in education and expectation management with their patients and their families to leave room for hopeful uncertainty in a life with severe illness. Lastly, in their paper on mental health care infrastructure in Berlin and Brandenburg, Patrick Bieler, Milena D. Bister and Christine Schmid (all Humboldt-Universität zu Berlin) mapped out emergent and shifting “ecologies of expertise” (Beck 2015) that move beyond the hospital and institutional forms of psychiatric expertise into patients’ homes and socio-material surroundings.

Revisiting healing rituals

The healing ritual represents a traditional topic of investigation in the history of anthropology, starting as early as 1969 with Victor Turner’s symbolic analysis of Ndembu rituals in Zambia (Turner 1969). Some of the workshop papers engaged with healing rituals and asked which form this “anthropological classic” takes, if approached within an ecological framework. Using Ingold’s notion of the “ecology of life”, defined as “the creative unfolding of an entire field of relations within which beings emerge” (Ingold 2000, 19), Mona Schrempf (Humboldt-Universität zu Berlin) analyzed the ritual of a Bhutanese healing medium who is possessed by a local mountain goddess. In the ritual healing, Schrempf argued, cosmo-ontologies are co-produced between the medium and the patient, the arrangement of objects brought into the patient’s house and the involvement of the neighbors, thereby fusing the patient’s body, ecological and cosmological networks as well as ancestral history. Alvaro Gabriel Martínez (Universidad Católica Boliviana) introduced the audience to healing rituals in the Andean region in and around La Paz, Bolivia. He presented different techniques through which ritual and medical specialists diagnose and treat “soul diseases” and argued that in the interpretation of coca leaves and of the clients’ drawings, the healers engage with the clients as “issuers of symbols.” In the ritualistic burning of offerings, symbols are more than carriers of meaning – they are turned into operators to reestablish a cosmological order and thereby achieve healing for the client. Lastly, Mike Poltorak’s presentation of filmic sequences of rituals performed by a Tongan healer showed that the “anthropological classic” can also be revisited through methodological innovations. Poltorak showed his footage to different actors in his field at different points of time to make sense of epistemological and temporal gaps and intersections between the (unbelieving) anthropologist, a traditional healer, her clients and a psychiatrist. These presentations showed that in order to work with an ecological approach it does not suffice to reframe our ethnographic material in new ways. We also must ask different questions and follow different lines of investigation in order to account for complex interrelations between the actors constituting a healing ecology.

Diagnosis made by the Ritual and Medical Specialist Gonzalo Ávila on a drawing made by the researcher Alvaro Martínez. Source: Alvaro Martínez

Discussion

In her short story “Social Dreaming of the Frin” the late science fiction author Ursula K. Le Guin (the “K” being a reminder of her father, the cultural anthropologist Alfred Kroeber) imagines a world in which the inhabitants of the “Frinthian Plane” share their dreams up to a point where it’s difficult to tell which chimera was a figment of their own and which emerged from a different dreamer. The human narrator discusses this dream ecology in the manner of an anthropological investigation:

“For them, dream is a communion of all the sentient creatures in the world. It puts the notion of the self deeply into question. I can imagine only that for them to fall asleep is to abandon the self utterly, to enter or reenter the limitless community of being, almost as death is for us.” (Le Guin 2005: 86).

Using Bateson’s writing as a starting point and inspiration, the presentations pointed to a variety of ecologies that – like on the “Frinthian Plane” – question monolithic entities like the self or the body by highlighting their constitution in manifold relations with their human and more-than-human companions.

At the end of the workshop we feel inspired. Clearly something caused the animated discussions during the coffee breaks, at dinner, and in the sessions themselves. But what exactly was it? What threads came together in this invitation to think about ecologies of mind? How to make sense of the similarities between the remote cases? Did we fall for the attempt to simply develop an anthropological “theory of everything”? The question remains what exactly we mean when speaking about ecology. A diversity of interpretations and applications of the concept were presented in the papers, but also a variety of scopes and dimensions: Do we use ecology as a heuristic device? Do we study it as an object? Or is it rather a method, or a way to frame our research questions? This also bears the question in which ways ecologies of mind/life/expertise add to or converge with recent discussions about assemblages and actor-networks.

The participants concurred that ecology should not be used as only a biological metaphor to describe a linear process of adaption to an environment. Instead, ecology emerges in relations: between the ever-changing organism and their always context-specific environments – “a flexible organism-in-its-environment” (Bateson 1978: 451). The presentations showed that following objects – be they trees or medical plants – as “densifications” of complex socio-material interrelations is a viable methodological approach. Thinking ecologically, thus, goes beyond considering the relationship between social and material worlds in symbolic or representational terms to, instead, account for and take seriously material conditions and the agency of non-human actors in our analyses of the social. This, however, opens up new questions regarding the status of anthropology: To what extent should we collaborate with natural scientists on the one hand, and how do we appreciate indigenous ontologies without romanticizing them as the “better” alternative to Science on the other hand?

It seems most fruitful to see the workshop as a first step to descriptively explore the status quo of anthropological enquiries into the mind beyond the body and brain, and into ecologies of care. And in this first step, perhaps we don’t have to define and agree on one definition and dimension of ecology – after all, the call was for multiple ecologies. The workshop certainly succeeded in its goal to create, as one of the organizers put it, an “accommodating framework” to speak to each other. It built a “site of encounter” that is at the same time a “site of difference,” linking participants in a “conversation that produces connections without producing closure” (De la Cadena et al. 2015). Fragmentary insights and partial connections perhaps shouldn’t be asked to conform “too smoothly to the smugness of coherence” (ibid.: 440). A next step should nevertheless be to move beyond description and examine the (power) relations and political economy produced in and productive of these ecologies.

Instead of drawing a romanticized picture of the deep and harmonious connection of all beings, as it is present in Le Guin’s story, the regionally and thematically diverse presentations showed poignantly that medical anthropologists need to critically focus on complicated and power-laden interrelations between entities that traverse clear-cut distinctions between the material and the social world, between self and other, between the mind and its surroundings. Landscapes, histories and spirits, as well as substances, practitioners and patients form part of and are formed within the heterogenous practices of achieving and maintaining (mental) health. The question “Where is my mind?” does not ask for a definite location but represents an appeal to practice medical anthropology in more-than-human worlds.

 

[1] A version of this report will also be published later this year in Curare – Journal of Medical Anthropology 42 (1+2).

 

Bio statements

Max Schnepf has obtained his Master of Science at the University of Amsterdam. As part of the master’s program in Social Sciences, he conducted ethnographic fieldwork at an upmarket hairdressing salon in Berlin about bodies in styling practices. He documents his research on the fieldwork blog www.anthrobod.net.

Karoline Buchner is an MA student at the Institute of Social and Cultural Anthropology at Freie Universität Berlin as well as a student assistant at the institute’s Medical Anthropology Research Area. She conducted field research on informal and professional Chinese medicine in Taiwan. She is also a research associate at the Institute of Chinese Life Sciences at Charité Berlin.

 

References

Bateson, Gregory. 1978. Steps to an Ecology of Mind. New York: Ballantine.

Beck, Stefan. 2015. The Problem of Expertise: From Experience to Skilful Practices to Expertise. In: European Journal of Pragmatism and American Philosophy 7 (1): 1–15.

De la Cadena, Marisol, Marianne E. Lien, Mario Blaser, Casper Bruun Jensen, Tess Lea, Atsuro Morita, Heather Swanson, Gro B. Ween, Paige West, and Margaret Wiener. 2015. Anthropology and STS: Generative Interfaces, Multiple Locations. In: HAU: Journal of Ethnographic Theory 5 (1): 437–75.

Ingold, Tim. 2000. The Perception of the Environment: Essays on Livelihood, Dwelling and Skill. New York, London: Routledge.

Kirksey, S. Eben and Stefan Helmreich. 2010. The Emergence of Multispecies Ethnography. In: Cultural Anthropology 25 (4): 545–76.

Kohn, Eduardo. 2015. Anthropology of Ontologies. In: Annual Review of Anthropology 44: 311–27.

Le Guin, Ursula K. 2005. Changing Planes. New York: Ace.

Turner, Victor. 1969. The Ritual Process: Structure and Anti-Structure. Chicago: Aldine.

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