Transforming Therapy

Whitney L. Duncan

Description

Oaxaca is known for many things—its indigenous groups, archaeological sites, crafts, and textiles—but not for mental health care. When one talks with Oaxacans about mental health, most say it's a taboo topic and that people there think you "have to be crazy to go to a psychologist." Yet throughout Oaxaca are signs advertising the services of psicólogos; there are prominent conferences of mental health professionals; and self-help groups like Neurotics Anonymous thrive, where participants rise to say, "Hola, mi nombre es Raquel, y soy neurótica."

How does one explain the recent growth of Euroamerican-style therapies in the region? Author Whitney L. Duncan analyzes this phenomenon of "psy-globalization" and develops a rich ethnography of its effects on Oaxacans' understandings of themselves and their emotions, ultimately showing how globalizing forms of care are transformative for and transformed by the local context. She also delves into the mental health impacts of migration from Mexico to the United States, both for migrants who return and for the family members they leave behind.

This book is a recipient of the Norman L. and Roselea J. Goldberg Prize from Vanderbilt University Press for the best book in the area of medicine.

Sujets

• Médecine
• Spécialités médicales
• Latin American Studies
• Mental Health
• Medical
• CAB Direct (database)
• Anthropology
• Health

Informations

• Publié par: Vanderbilt University Press
• Date de parution: 24 juillet 2018
• Nombre de lectures: 0
• EAN13: 9780826521996
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

Transforming Therapy
Transforming Therapy
Mental Health Practice and Cultural Change in Mexico

Whitney L. Duncan
Vanderbilt University Press
Nashville
© 2018 by Vanderbilt University Press
Nashville, Tennessee 37235
All rights reserved
First printing 2018
This book is printed on acid-free paper.
Manufactured in the United States of America
Library of Congress Cataloging-in-Publication Data
Library of Congress Cataloging-in-Publication Data on file
LC control number 2017055304
LC classification number RC455.4.E8
Dewey classification number 362.196/890097274—dc23
LC record available at lccn.loc.gov/2017055304
ISBN 978-0-8265-2197-2 (cloth)
ISBN 978-0-8265-2198-9 (paperback)
ISBN 978-0-8265-2199-6 (ebook)
This book is the recipient of the Norman L. and Roselea J. Goldberg Prize from Vanderbilt University Press for the best project in the area of medicine.
For my parents, Donnetta Duncan, and Wallace LaMar Duncan , y para AHR
Contents
Acknowledgments
Preface: Convivencias
Introduction
1. Go Where There Is No Path and Leave a Trail
2. Psicoeducación in the Land of Magical Thoughts
3. Prozac and Pura Plática
4. Transnationally Shaped Sentiments
5. Psy-Sociality at La Paz
Conclusion: Transforming Therapy
Notes
References
Index
Acknowledgments
This project has benefitted from the support, guidance, feedback, and patience of so many people. First, I am immensely grateful to those in Oaxaca who have opened their lives and homes to me, displayed enthusiasm for the project, and graciously shared their stories. I would like to specially thank AHR, whose courage humbles me and whose friendship I will always treasure. Many, many thanks also to the Cruz del Sur hospital patients who, often under painful circumstances, took time to speak with me, and to the families in the Mixteca who fed me, housed me, and befriended me. Mil gracias .
Also in Oaxaca, I am grateful to the psychiatrists and administrators at Cruz del Sur, the staff at Servicios de Salud de Oaxaca, and the many independent mental health practitioners and therapists who shared their expertise.
Thanks to Aerin Dunford, Arturo Jarquin, and Candelaria Gómez for their exceptional research assistance and insights. Andrea Belarruti provided translation help, and Santiago Renato Efrain Ramirez Ortiz, Rebeca Aracely Avendaño Méndez, Erica López Alonso, Jenny Hernández, Erich A. Hernández, Josely Germain Cruz Gómez, Norma Vásquez Jiménez, María de Montserrat Ordoñez Narváez, Rosa María Flores Lepe, Luis Adrián Fernández Ortega, Edelmira Pérez Hernández, and Roque Infanzón Mendoza provided research, interview, and transcription assistance.
I am indebted to Paul Hebb and Karen Rasmussen for generously housing me and providing beautiful spaces in which to work in Oaxaca. For friendship, moral support, and constant laughter during fieldwork and beyond, I thank Megan Martin, Shane Dillingham, Karen Rasmussen, and Holly Worthen. Fellow fieldworker Abigail Andrews could always be counted on for fun and stimulating exchanges. John Burch and Carl Owens have been much-appreciated sources of friendship and logistical help. Angelina Trujillo, Marcos Cruz Bautista, and Juan Julian Caballero were excellent Mixtec teachers who graciously invited me into their communities and patiently answered my many questions. The curanderas at the Clínica de Medicina Tradicional were extremely generous with their expertise as well. Thanks also goes to all the members of The Hub Oaxaca who made me feel welcome.
There are many people I wish to acknowledge at the University of California, San Diego, where I was trained as an anthropologist and where the seeds of this project were sown and nurtured. First and foremost, Janis Jenkins has provided immeasurable support throughout my career and has believed in and greatly enriched this project from its inception. Her brave insistence that anthropology must attend to experiences of mental health and illness gave me courage to pursue the questions I do in this book. I am extremely fortunate to have her as a mentor and a friend. Tom Csordas’s mentorship and intellectual legacy have also been very influential to my development as a scholar. Wayne Cornelius, John Haviland, Tom Patterson, Nancy Postero, Steve Parish, Keith McNeal, and Kit Woolard offered invaluable guidance, critiques, and insights. My training as an anthropologist and social scientist was significantly enhanced through my participation in SWYEPT and MMFRP—I thank Janis Jenkins, Tom Csordas, Wayne Cornelius, and David Fitzgerald for those opportunities.
I am extremely grateful to Bridget Haas for her encouragement, close chapter readings, and invaluable feedback throughout every stage of this project, in particular, the book chapter drafting and editing. Our ongoing dialogue and Bridget’s superb ethnographic sensitivity has helped shape so much of what lies in these pages. Allen Tran, too, has been an incisive reader and interlocutor whose work on mental health and subjectivity stimulates my own. I have cherished my friendships and intellectual exchanges with Charlotte Hajer and Ted Gideonse, both of whom helped me learn the importance of close attention to experience, agency, and good writing.
Other anthropology friends and colleagues, including Jess Novak, Heather Spector Hallman, Ana Pimentel Walker, Nofit Itzhak, Sarah Horton, Elizabeth Carpenter-Song, Julia Cassaniti, Jon Yahalom, and Sonya Pritzker, have inspired and challenged me as well. I’m indebted to Kristin Yarris for detailed, incisive comments on early chapter drafts and for thought-provoking discussions about migration and Mexican psychiatry. Peter Guarnaccia, Roberto Lewis-Fernández, and Devon Hinton have provided mentorship and feedback over the years. I thank Neely Myers for introducing me to Vanderbilt University Press and for her anthropological attention to mental illness and recovery.
Colleagues at the University of Northern Colorado welcomed me with open arms and have provided an academic home for me since then. Thanks to Sally McBeth, Britney Kyle, Andy Creekmore, Mike Kimball, Trish Jolly, Ather Zia, and Brooks Pardew. My students at UNC have asked probing questions and have pushed me to think about how anthropologists communicate to undergraduate audiences.
Michael Ames, director of VUP, expertly ushered this manuscript from rough draft to finished product. I am extremely grateful for his encouragement, dedication, and editorial guidance. Joell Smith-Borne, VUP’s managing editor, also helped immensely on the road to publication.
The book was significantly improved by several anonymous manuscript reviewers, who pushed me to think harder and write better. Their detailed and insightful feedback helped sharpen every aspect of this book.
This project would not have been possible without a National Science Foundation grant (Award #1026819) as well as various grants and fellowships from the University of California and the University of Northern Colorado.
Finally, I am tremendously fortunate to have a network of friends and family who have nurtured and challenged me through the years. In particular, I owe a great debt of gratitude to my parents for taking every opportunity to foster my curiosity and for insisting that I pursue my passions. I have kept the memory of my father, Wallace LaMar Duncan, close throughout fieldwork and writing. His discipline, perspicacity, and love of stories have profoundly influenced my life and work. My mother, Donnetta Duncan, has always believed in me, provided unwavering support, and made sure to remind me that it is only “as fun as you make it.”
Most of all, Joel Johnson’s love, patience, and support—moral, intellectual, emotional—has helped me through every stage and page of this project and continues to inspire me daily. Our life together nourishes and sustains me. Thank you. You and our daughters are everything to me.
Preface
Convivencias
It was Día de los Muertos, and I had gathered cigarettes, wine, fruit-flavored Mentos, and an old photo of my father to add to my friend’s family altar. They had built a double-arch of marigold flowers interspersed with orange, jicama, tomatoes, guayaba, and other fruit, under which lay dozens of family photos, candles, traditional pan de muertos , sugar skulls, cups of coffee on saucers, and more piles of fruit. Over the course of several days, a film formed over the coffee and the insides of the mugs showed rings where the coffee had evaporated, creating the impression that our difuntos (dead) had, indeed, been taking sips when we weren’t looking. Chairs were set up in front of the altar and, in turns, we sat to convivir with our difuntos and with each other. In homes and cemeteries all around us, others were doing the same. How heavy the years since my father had passed away felt upon me, and how deeply I appreciated that convivencia with him and with living friends as I alternately grieved his death and celebrated his life. 1
The Spanish word convivir has multiple meanings: to live in the company of others, to get along with others, to coexist with others, to visit with and interact with others. I view anthropological research and writing as a long process of being-with, or convivencia. 2 Living in Oaxaca, sharing life with others; returning for briefer visits, seeking to maintain relationships with people and places; listening to recordings of interviews, events, reliving them from a distance, then analyzing them; writing about those with whom I interacted: all of this is part of ethnographic convivencia. Writing this from my home in Colorado, with my Oaxacan friend Amapola’s voice fresh in my ears from a quick phone call, recent emails from Oaxacan research collaborators in my inbox, and a Oaxacan black clay calavera (skull) looking back at me from my desk, I feel acutely the ways in which this convivencia is ongoing, and I consider how to convey it using the written word.
Nine months befo