Disturbing Spirits

Beverly A. Tsacoyianis

Description

This book investigates the psychological toll of conflict in the Middle East during the twentieth century, including discussion of how spiritual and religious frameworks influence practice and theory.

The concept of mental health treatment in war-torn Middle Eastern nations is painfully understudied. In Disturbing Spirits, Beverly A. Tsacoyianis blends social, cultural, and medical history research methods with approaches in disability and trauma studies to demonstrate that the history of mental illness in Syria and Lebanon since the 1890s is embedded in disparate—but not necessarily mutually exclusive—ideas about legitimate healing. Tsacoyianis examines the encounters between “Western” psychiatry and local practices and argues that the attempt to implement “modern” cosmopolitan biomedicine for the last 120 years has largely failed—in part because of political instability and political traumas and in part because of narrow definitions of modern medicine that excluded spirituality and locally meaningful cultural practices.

Analyzing hospital records, ethnographic data, oral history research, historical fiction, and journalistic nonfiction, Tsacoyianis claims that psychiatrists presented mental health treatment to Syrians and Lebanese not only as a way to control or cure mental illness but also as a modernizing worldview to combat popular ideas about jinn-based origins of mental illness and to encourage acceptance of psychiatry. Treatment devoid of spiritual therapies ultimately delegitimized psychiatry among lower classes. Tsacoyianis maintains that tensions between psychiatrists and vernacular healers developed as political transformations devastated collective and individual psyches and disrupted social order. Scholars working on healing in the modern Middle East have largely studied either psychiatric or non-biomedical healing, but rarely their connections to each other or to politics. In this groundbreaking work, Tsacoyianis connects the discussion of global responsibility to scholarly debates about human suffering and the moral call to caregiving. Disturbing Spirits will interest students and scholars of the history of medicine and public health, Middle Eastern studies, and postcolonial literature.

Anglophone and Francophone scholars who have worked on healing in the twentieth century Middle East have largely studied either psychiatry or spirit-based healing, but they have rarely studied both and their connection to political changes. The development of psychiatric treatment in the Middle East has largely been a story told through French, British, or American roles in developing asylums, hospitals, and schools, or through regional efforts to combat foreign control, as with Mehmet ʿAli’s schools and army in Egypt. While historians focus on psychiatric institutions, anthropologists analyze the culturally specific role of jinn (spirits) and magic, with some brief forays into the nebulous area between Jinn-possession and psychiatric notions of mental illness. Anthropologist Celia Rothenberg, for example, notes a 1996 report where Palestinian Psychiatrist Eyad Sarraj (director of the Gaza Community Mental Health Program [GCMHP]) considered political context important to etiology and treatment, but he did not “recogniz[e] the role of sheikhs in ‘curing’ patients of their problems.”

Scholars cannot fully comprehend the significance of psychiatric history to the development of the modern Syrian and Lebanese states without considering the political contexts of natural and supernatural understandings of mental illness. This study challenges the binary nature of research that separates foreign from local spaces of knowledge and practice, and it joins other histories of medicine and psychiatry that, as Matthew Heaton notes, “break down artificial dichotomies between colonizer/colonized, traditional/modern, and science/belief at local and national levels.”

These issues present conceptual difficulties in the Eastern Mediterranean as in other parts of the world, particularly in areas with minority groups and a history of repressive rule. One must avoid an oversimplified narrative of suffering and exploitation at the hands of cruel, racist, or imperialist doctors, as well as an oversimplified narrative of heroic resistance to the medical encounter. Steven Epstein’s concept of biopolitical citizenship moves beyond such binaries to highlight how “political issues of justice and equality get worked out in a biomedical domain.” Applying this to the Syrian and Lebanese context can highlight how war, repression, sectarianism, and medical marginalizing of nonmedical practices produced silences and traumas. The binary of suffering and resistance is one challenge for historians. Another is balancing two simultaneous historiographic agendas. The first deconstructs positivist attitudes towards science and culture, as science is the product of complex cultural formations.

The other agenda challenges essentialist views about static “Islamic” cultures or sciences by showing they (like cultures and sciences outside the Islamic world) are dynamic and organic processes. The book frames arguments about healing in the later chapters within the traumatic legacies wrought by political upheavals addressed in the early chapters. It moves from discussion of health and treatment in the early twentieth century, World War I, and the French Mandate period to analysis of continuities and ruptures in treatment during and after political upheavals of the postcolonial periods, particularly the 1958 “crisis” in Lebanon, the coups and Baʿathist repression in Syria, the Lebanese Civil War and the Syrian civil war. This postcolonial period (from the late 1940s to the post-9/11 Middle East) has witnessed numerous important political and economic changes in Greater Syrian society that continue to shape a diverse health arena.

Introduction

1. Vernacular Healing in Greater Syria

2. The Origins of Greater Syrian Medical Institutions

3. Medical Missionaries and the Lebanon Mental Hospital, 1899–1983

4. Secular Healing and Ibn Sina Mental Hospital, 1922–2018

5. Literature, Civil War, and (Ef)facing Syrian and Lebanese History

Conclusion

Sujets

• Médecine
• Spécialités médicales
• Middle Eastern Studies
• Ethnic Studies
• Middle Est
• Mental Health
• Middle Eastern
• HISTORY
• POLITICAL SCIENCE
• Histoire
• General officer
• List of conflicts in the Middle East
• Middle East
• World
• General

Informations

• Publié par: University of Notre Dame Press
• Date de parution: 15 juin 2021
• Nombre de lectures: 0
• EAN13: 9780268200749
• Langue: English

Extrait

DISTURBING SPIRITS
DISTURBING SPIRITS

Mental Illness, Trauma, and Treatment in Modern Syria and Lebanon
BEVERLY A. TSACOYIANIS
University of Notre Dame Press
Notre Dame, Indiana
University of Notre Dame Press
Notre Dame, Indiana 46556
undpress.nd.edu
All Rights Reserved
Copyright © 2021 by University of Notre Dame
Published in the United States of America
Library of Congress Control Number: 2021931605
978-0-268-20072-5 (Hardback)
978-0-268-20071-8 (WebPDF)
978-0-268-20074-9 (Epub)
This e-Book was converted from the original source file by a third-party vendor. Readers who notice any formatting, textual, or readability issues are encouraged to contact the publisher at [e-mail]
CONTENTS Acknowledgments List of Abbreviations A Note on Transliteration Introduction ONE Vernacular Healing in Greater Syria TWO The Origins of Greater Syrian Medical Institutions THREE Medical Missionaries and the Lebanon Mental Hospital, 1899–1983 FOUR Secular Healing and Ibn Sina Mental Hospital, 1922–2018 FIVE Literature, Civil War, and (Ef)facing Syrian and Lebanese History Conclusion: On Pain, Surviving, Coping, and Healing Appendix Notes Bibliography Index
ACKNOWLEDGMENTS
Research and writing for this book (and for the dissertation on which this is partly based) were made possible thanks to funding from the Fulbright-Hays Doctoral Dissertation Research Abroad award administered by the United States Department of Education in 2009, the Chancellor’s Graduate Fellowship Award and the International and Area Studies travel grant from Washington University in St. Louis, a 2011 P.E.O. Scholar award administered by P.E.O., an international Philanthropic Educational Organization for women’s education, a Marcus Orr Center for the Humanities (MOCH) Freeburg Fellowship in 2017, and a Professional Development Assignment (PDA) at the University of Memphis in 2018.
In the United States, I am thankful for the guidance I received in graduate school (and since, in Nancy’s case) from my main advisors Nancy Reynolds and Timothy Parsons, as well as from Ahmet Karamustafa, Hillel Kieval, and Jonathan Sadowsky. I am also grateful for the input of Nancy Berg, who showed me the exciting directions interdisciplinary work could take when informing medical and social history research with approaches in comparative literature and film studies. My gratitude also goes to Kristina Richardson and Sara Scalenghe for encouraging this project at annual meetings of the Middle East Studies Association (MESA) and the American Historical Association when I was in grad school, and again at a small but excellent workshop on Middle Eastern Disability History at the University of Maryland in November 2015. Sara also generously provided me with digital copies of numerous primary sources from Asfuriyeh Mental Hospital and gave me feedback on a 2018 MESA paper based on parts of this book. My appreciation also goes to Dr. David Satin at Harvard Medical School for inviting me to present in the colloquium series in the History of Medicine and Psychiatry in December 2013. I also treasure the connections I made with many women whose paths as academics, administrators, or students intersected with mine over the years, whose conversations, meals, advice, and laughter nourished me as I grew from graduate student new to archives to more seasoned traveler and early career professional, including Elsa Abou Assi, Michela Gatti, Anneka Lenssen, Sheri Notaro, and Michaela Sinibaldi. In Memphis, a Professional Development Assignment in fall 2018 and the MOCH Catherine and Charles Freeburg Faculty Fellowship in spring 2017 afforded me the time to work on the book proposal and parts of the manuscript. Conversations I had with then MOCH director Sarah Potter and MOCH fellows Melanie Conroy, Kathryn Hicks, and Carey Mickalites advanced my thinking on source analysis and thematic connections across disciplines. I am also deeply thankful to my colleagues in the University of Memphis Department of History for their friendship and advice: my department chairs Janann Sherman, Aram Goudsouzian, and Dan Unowsky, Beverly Bond, Peter Brand, Peggy Caffrey, Michele Coffey, Charles Crawford, Andrew Daily, Guiomar Dueñas-Vargas, Christine Eisel, Jim Fickle, Chrystal Goudsouzian, Benjamin Graham, Brian Kwoba, Denis Laumann, Scott Marler, Greg Mole, Susan O’Donovan, Suzanne Onstine, Catherine Phipps, Sarah Potter, Amanda Lee Savage, Steve Stein, Cookie Woolner, and Andrei Znamenski, among others. Graduate students in my department and in the Department of Communication were also helpful, especially Noor Ghazal Aswad, Matt Isaacs, Kalemba Kizito, and Andrea Ringer. A very special thank-you goes to Peggy Caffrey for carefully reading the entire manuscript as it neared completion; her guidance erased long passages as if by magic and with surgical precision. I also thank the editorial staff at the University of Notre Dame Press, especially Eli Bortz, Rachel Kindler, and Elizabeth Sain, for their patience, good humor, expertise, and support, and I thank the two anonymous reviewers for their detailed reports.
In France and the United Kingdom, I am indebted to the staff of the government archives in Nantes, Paris, and Kew Gardens. I am especially thankful to archivists and officers of the Val-de-Grâce Psychiatric Hospital and of the Service Historique de la Défense at the Château de Vincennes, and to archivist Debbie Usher at the Middle East Centre Archives of St. Antony’s College, Oxford University. In Lebanon, though I largely worked remotely with records from Saab Medical Library, I appreciate the archivists of the Arabic Collections Online, especially Elie Kahale, Director of Digital Initiatives and Scholarship at American University of Beirut, and Samar Mikati, Associate University Librarian for Archives and Special Collections at American University of Beirut, for their permissions and assistance in securing high-resolution images of the Lebanon Hospital data in the appendix.
In Syria, I would like to thank the staff and scholars affiliated with the Institut Français du Proche-Orient (IFPO) in Damascus, civil servants in the Syrian Ministry of Culture and Syrian Ministry of Health who approved my research access to government hospital records in 2009 and 2010, and employees of Ibn Sina Mental Hospital, especially former director Dr. ʿAbdul-Massih Khalaf and former staff psychiatrists Dr. Mahmood Naddaf and Dr. Usama Alshughry, among others, for their generosity, research, and friendship as I collected my data in 2009 and 2010 and in conversations we’ve had in the years since then. I am also thankful for the kindness and vision of Syrians like Mustafa Alhaj Ahmed, whose hard work as founder and principal of the Tuyoor Al-Amal Schools has helped thousands of Syrian refugee children who found their way to Lebanon. In Jordan I am grateful to the staff and scholars at the IFPO in Amman, to Syrian psychologist Adnan Al Rebdawi, and to Syrian psychiatrist Mohammad Abo Hilal for their insights and generosity. I also thank Syrian artist and musician Anas Homsi, born and raised in Damascus, for his permission to incorporate his “Wall of Memories,” painted while he was a refugee in Lebanon in 2015 and sold in the United States in 2018, as part of this book’s cover design. I found his generosity in our conversations via video chat and email in 2020 while he, his half-Syrian half-Lebanese wife (also an artist and musician), and their young son live in Germany deeply inspiring.
I owe a very special debt of gratitude to family and friends, particularly my mother, Sylvia Maria Reyes Levine, and my father, Robert Alan Levine, for encouraging me, my sister, Amy, whose resilience gives me hope, and my husband, Matt, for helping me through times I was unable to cope with challenges on my own. In the last few years, as Matt and I have welcomed our children into our lives, we experienced the incredible awe and joy of seeing these fragile-looking little bodies grow and thrive in a country where they have easy access to urgent care, clean food and water, safe shelter, antibiotics, and routine checkups and vaccinations. I cannot fathom the pain of those who have lost their children and whose lives have been destroyed in the Lebanese and Syrian civil wars. I dedicate my book to all survivors as I mourn for you and your grieving families. I can only imagine how horribly the mind and spirit breaks in such outrageous circumstances, so let us be grateful for the experts, both medical and religious, who make it their duty and respond to that calling to comfort the wounded and to try to heal against all odds. I have fond memories of good people, compassionate healers, and remarkable places in Syria and Lebanon. Let us hope (and work) for a peaceful resolution to violent conflict, and for effective and meaningful healing systems to care for all victims of physical, mental, and emotional trauma. For the children, for their families, and for us all, as the prayer goes: “may we see the day when war and bloodshed cease, when a great peace will embrace the whole world.”
ABBREVIATIONS
AUB American University of Beirut
BNA British National Archives
CADN Centre des Archives Diplomatiques de Nantes, France
ECT Electroconvulsive Therapy
EST Electroshock Therapy
IFPO Institut Français du Proche-Orient
ISHR Ibn Sina Hospital Record
LH Lebanon Hospital for Nervous and Mental Disorders at Asfuriyeh
MAE Ministère des Affaires Étrangères, France
SOAS School of Oriental and African Studies
SPC Syrian Protestant College (renamed AUB in 1921)
A NOTE ON TRANSLITERATION
I follow a simplified version of the system used in the International Journal of Middle East Studies . Except for the ʿ ayn (ʿ) and hamza (ʾ), I omit case endings and diacritical marks in the body of the text but retain diacritics in the footnotes and bibliography. For words in English and French sources, I retain spelling where appropriate (for