Being Brains: Making The Cerebral Subject

Chap. 3: Cerebralizing Distress

Globalization of Psychiatry


Psychopharmaceutical marketing has also contributed to the globalization of psychiatry and the high prevalence of depression, as documented by research in India (Ecks 2013, Ecks and Basu 2009, Sumeet and Jadhav 2009), Japan (Appelbaum 2006, Kirmayer 2002, Kitanaka 2011), Brazil (Béhague 2009; Biehl 2005, 2006; Leibing 2009) and Argentina (Lakoff 2005, 2006).


While ethnographic studies tend to corroborate the existence of a global psychopharmaceutical hegemony (Good 2010), the distribution of spending on pharmaceuticals is strongly asymmetric and is determined by economic incentives (Petryna and Kleinman 2006). In the area of mental health, the result is overdiagnosis and overmedication in the richest countries and dismal negligence in the poorer ones (Kleinman 2012).

Such an imbalance in the distribution of resources must be placed in the framework of the discussion concerning the contribution of mental disorders to the global burden of disease (GBD) as measured in Disability-Adjusted Life Years (DALYs, or number of years lost due to ill health, disability, or early death).


List of studies cited by Vidal and Ortega

India

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Summary of Eating Drugs: Psychopharmaceutical Pluralism in India

A Hindu monk in Calcutta refuses to take his psychotropic medications. His psychiatrist explains that just as his body needs food, the drugs are nutrition for his starved mind. Does it matter how—or whether—patients understand their prescribed drugs?

Millions of people in India are routinely prescribed mood medications. Pharmaceutical companies give doctors strong incentives to write as many prescriptions as possible, with as little awkward questioning from patients as possible. Without a sustained public debate on psychopharmaceuticals in India, patients remain puzzled by the notion that drugs can cure disturbances of the mind. While biomedical psychopharmaceuticals are perceived with great suspicion, many non-biomedical treatments are embraced.

Stefan Ecks illuminates how biomedical, Ayurvedic, and homeopathic treatments are used in India, and argues that pharmaceutical pluralism changes popular ideas of what drugs do. Based on several years of research on pharmaceutical markets, Ecks shows how doctors employ a wide range of strategies to make patients take the remedies prescribed. Yet while metaphors such as "mind food" may succeed in getting patients to accept the prescriptions, they also obscure a critical awareness of drug effects.

This rare ethnography of pharmaceuticals will be of key interest to those in the anthropology and sociology of medicine, pharmacology, mental health, bioethics, global health, and South Asian studies.

Japan

Book cover. Image from Amazon.

Summary of Depression in Japan: Psychiatric Cures for a Society in Distress

Since the 1990s, suicide in recession-plagued Japan has soared, and rates of depression have both increased and received greater public attention. In a nation that has traditionally been uncomfortable addressing mental illness, what factors have allowed for the rising medicalization of depression and suicide? Investigating these profound changes from historical, clinical, and sociolegal perspectives, Depression in Japan explores how depression has become a national disease and entered the Japanese lexicon, how psychiatry has responded to the nation's ailing social order, and how, in a remarkable transformation, psychiatry has overcome the longstanding resistance to its intrusion in Japanese life.

Questioning claims made by Japanese psychiatrists that depression hardly existed in premodern Japan, Junko Kitanaka shows that Japanese medicine did indeed have a language for talking about depression which was conceived of as an illness where psychological suffering was intimately connected to physiological and social distress. The author looks at how Japanese psychiatrists now use the discourse of depression to persuade patients that they are victims of biological and social forces beyond their control; analyzes how this language has been adopted in legal discourse surrounding "overwork suicide"; and considers how, in contrast to the West, this language curiously emphasizes the suffering of men rather than women. Examining patients' narratives, Kitanaka demonstrates how psychiatry constructs a gendering of depression, one that is closely tied to local politics and questions of legitimate social suffering.

Drawing upon extensive research in psychiatric institutions in Tokyo and the surrounding region, Depression in Japan uncovers the emergence of psychiatry as a force for social transformation in Japan.

Brazil

Book cover. Image source below.

Summary of Vita: Life in a Zone of Social Abandonment

Zones of social abandonment are emerging everywhere in Brazil’s big cities—places like Vita, where the unwanted, the mentally ill, the sick, and the homeless are left to die. This haunting, unforgettable story centers on a young woman named Catarina, increasingly paralyzed and said to be mad, living out her time at Vita. Anthropologist João Biehl leads a detective-like journey to know Catarina; to unravel the cryptic, poetic words that are part of the “dictionary” she is compiling; and to trace the complex network of family, medicine, state, and economy in which her abandonment and pathology took form.

An instant classic, Vita has been widely acclaimed for its bold fieldwork, theoretical innovation, and literary force. Reflecting on how Catarina’s life story continues, this updated edition offers the reader a powerful new afterword and gripping new photographs following Biehl and Eskerod’s return to Vita. Anthropology at its finest, Vita is essential reading for anyone who is grappling with how to understand the conditions of life, thought, and ethics in the contemporary world.

Argentina

Book cover. Image source below.

Summary of Pharmaceutical Reason: Medication and Psychiatric Knowledge in Argentina

When a French biotechnology company seeks patients in Buenos Aires with bipolar disorder for its gene discovery program, they have unexpected trouble finding enough subjects for the study. In Argentina, the predominant form of mental health expertise - psychoanalysis - does not recognize the legitimacy of bipolar disorder as a diagnostic entity. This problem points to a broader set of political and epistemological debates in global psychiatry. Drawing from an ethnography of psychiatric practice in Buenos Aires, Andrew Lakoff follows the contested extension of novel techniques for understanding and intervening in mental illness. He charts the globalization of the new biomedical psychiatry, and illustrates the clashes, conflicts, alliances, and reformulations that take place when psychoanalytic and biological models of illness and cure meet. Highlighting the social and political implications that new forms of expertise about human behavior and thought bring, Lakoff presents an arresting case study that will appeal to scholars and students alike.

This last article, as well as some of the others, are part of the book above, Global Pharmaceuticals, edited by Adriana Petryna, Andrew Lakoff, and Arthur Kleinman. If you're interested in exploring further, click below to find the book:

Description of Global Pharmaceuticals

In some parts of the world spending on pharmaceuticals is astronomical. In others people do not have access to basic or life-saving drugs. Individuals struggle to afford medications; whole populations are neglected, considered too poor to constitute profitable markets for the development and distribution of necessary drugs. The ethnographies brought together in this timely collection analyze both the dynamics of the burgeoning international pharmaceutical trade and the global inequalities that emerge from and are reinforced by market-driven medicine. They demonstrate that questions about who will be treated and who will not filter through every phase of pharmaceutical production, from preclinical research to human testing, marketing, distribution, prescription, and consumption.

Whether considering how American drug companies seek to create a market for antidepressants in Japan, how Brazil has created a model HIV/AIDS prevention and treatment program, or how the urban poor in Delhi understand and access healthcare, these essays illuminate the roles of corporations, governments, NGOs, and individuals in relation to global pharmaceuticals. Some essays show how individual and communal identities are affected by the marketing and availability of medications. Among these are an exploration of how the pharmaceutical industry shapes popular and expert understandings of mental illness in North America and Great Britain. There is also an examination of the agonizing choices facing Ugandan families trying to finance AIDS treatment. Several essays explore the inner workings of the emerging international pharmaceutical regime. One looks at the expanding quest for clinical research subjects; another at the entwining of science and business interests in the Argentine market for psychotropic medications. By bringing the moral calculations involved in the production and distribution of pharmaceuticals into stark relief, this collection charts urgent new territory for social scientific research.

Watch these talks by the book's editors:

Being Brains: Making The Cerebral Subject

Inspired by the homonymous book by Fernando Vidal and Francisco Ortega, this timespace presents the authors' genealogy of the cerebral subject and the influence of the neurological discourse in human sciences, mental health and culture.

De Anima, by Aristotle On the Sacred Disease, by Hippocrates Edwin Smith surgical papyrus Galenic Corpus Aristotelianism The Tryal of Wits, by Juan Huarte Anatomy of Melancholy, by Robert Burton Passions of the Soul, by René Descartes Corpuscularianism The Anatomy of the Brain and Nerves, by Thomas Willis The Second Treatise of Government, by John Locke Essay Concerning Human Understanding, by John Locke Analytical Essay on the Faculties of the Soul, by Charles Bonnet Phrenology The Constitution of Man Considered in Relation to External Objects, by George Combe The Duality of the Mind, by Arthur Wigan Self-Help, by Samuel Smiles The case of Tan, studied by Paul Broca The New Thought or Mind Cure Movement The Brain Power of Man: Has He Two Brains or Has He One?, by Brown-Séquard First Book in Physiology and Hygiene, by John Harvey Kellogg New Methods in Education, by James Liberty Tadd Foundation of the British Ambidextral Culture Society Quote by Auguste Forel Quote by Oskar Vogt First human electroencephalogram (EEG) recorded The World, the Flesh, and the Devil, by J.D. Bernal Cybernetics Albert Einstein's death Widespread of the definition of death according to brain-based criteria in clinical practice Right-brain boom Self-Knowledge and Self-Identity, by Sidney Shoemaker Harvard Medical School landmark report Brain Transplantation and Personal Identity, by Roland Puccetti Philosophical Explanations, by Robert Nozick The Mind’s I, edited by Daniel C. Dennett and Douglas Hofstadter Reason, Truth, and History, by Hilary Putnam Beyond Structuralism and Hermeneutics, by Foucault Real People: Personal Identity Without Thought Experiments, by Kathleen Wilkes Technologies of the Self, by Michel Foucault Quote by James D. Watson Neuroplasticity Smart for Life, by Michael D. Chafetz Le philosophe et son scalpel: le problème de l'identité personnelle, by Stéphane Ferret Exploding the Gene Myth, by Ruth Rubbard and Elijah Wald Scott Gilbert's article about four biological views of the body/self—the neural, immunological, genetic, and phenotypic The DNA Mystique, by Dorothy Nelkin and Susan Lindee Japan's Organ Transplantation Law The Genetic Self, by June Peters Brain Death and Transplantation in Japan, by Masahiro Morioka The Executive Brain, by Elkhonon Goldberg Twice Dead: Organ Transplants and the Reinvention of Death, by Margaret Lock Foundation of the Posit Science Corporation Neurochemical Selves, by Nikolas Rose Jonathon Keats copyrights his brain Is It Me or My Brain? Depression and Neuroscientific Facts, by Joseph Dumit How to Talk About the Body? The Normative Dimension of Science Studies, by Bruno Latour Completion of the Human Genome Project The Ethical Brain, by Gazzaniga Article on Brain Calisthenics, at The New York Times Can neuroscience be integrated into the DSM-V?, by Steven Hyman A Social Neuroscience Perspective on Adolescent Risk-Taking, by Laurence Steinberg Identity, Identification, and the Brain, by Emily Martin Unresponsive Wakefulness Syndrome: A New Name for the Vegetative State or Apallic Syndrome, by Steven Laureys Withdrawal of Artificial Nutrition and Hydration for Patients in a Permanent Vegetative State: Changing Tack, by Catherine Constable A Stone in a Spaghetti Bowl: The Biological and Metaphorical Brain in Neuro-Oncology, by Sky Gross More Dead Than Dead: Perceptions of Persons in the Persistent Vegetative State, by Kurt Gray Constituting Neurologic Subjects: Neuroscience, Subjectivity, and the Mundane Significance of the Brain, by Pickersgill, Cunningham-Burley and Martin Émergence du moi cérébral de Théodore Meynert à Antonio Damasio, by Arminjon, Ansermet, and Magistretti The Transatlantic Divide Over Brain Death Determination and the Debate, by Wijdicks Rebelling Against the Brain: Public Engagement with the ‘Neurological Adolescent, by Choudhury, McKinney and Merten Neurobiological Narratives: Experiences of Mood Disorder Through the Lens of Neuroimaging, by Daniel Buchman Neurobiology in Public and Private Discourse: The Case of Adults with ADHD, by Broer and Heerings Neuro: The New Brain Sciences and the Management of the Mind, by Nikolas Rose and Joelle Abi-Rached How Has Neuroscience Affected Lay Understandings of Personhood?, by O'Connor and Joffe Beyond the Brain, by David Brooks David Brooks and the Anti-Neuroscience Backlash, by Paul Waldman The Problem with the Neuroscience Backlash, by Gary Marcus Brain Talk: Power and Negotiation in Children’s Discourse About Self, Brain, and Behavior, by Ilina Singh Death, treatment decisions and the permanent vegetative state: evidence from families and experts, by Stephen Holland The Embodied Brain, by Kiverstein and Miller Thomas Insel appointed head of the new life sciences unit of Alphabet
Primitive Culture, by Edward Burnett Tylor Coming of Age in Samoa, by Margaret Mead Culture: A Critical Review of Concepts and Definitions, by Alfred Kroeber and Clyde Kluckhohn Margaret Mead and Samoa: The Making and Unmaking of an Anthropological Myth, by Derek Freeman Keywords: A Vocabulary of Culture and Society, by Raymond Williams Thinking Through Cultures, by Richard Shweder Early use of the term social neuroscience Appearance of the term neuroanthropology in the Dictionary of Anthropology Topics researched in cultural neuroscience Social Neuroscience, by John T. Cacioppo and Gary Berntson Launch of the journal Social Neuroscience Launch of the journal Social Cognitive and Affective Neuroscience First appearance of the term cultural neuroscience Neural Basis of Cultural Influence on Self-Representation, by Zhu et al. Foundation of the Social and Affective Neuroscience Society Culture-sensitive neural substrates of human cognition: a transcultural neuroimaging approach, by Han and Northoff The first Ph.D. in Neuroanthropology Special Issues on Cultural Neuroscience Neural basis of individualistic and collectivistic views of the self, by Chiao et al. Foundation of the Society for Social Neuroscience Neuroanthropology vs. Cultural Neuroscience How Cultural is ‘Cultural Neuroscience’? Some Comments on an Emerging Research Paradigm, by Denkhaus and Bös Special Issues on Neuroanthropology The Encultured Brain, by Greg Downey and Daniel H. Lende Foundation of the journal Culture & Brain Cultural Neuroscience: Connecting Culture, Brain, and Genes, by Kitayama and Huff
Influence of psychoanalytic explanations Synthetization of Chlorpromazine The Divided Self, by Ronald Laing National Autistic Society Autism Society of America Psychiatry and Anti-Psychiatry, by David Cooper Mental Patients' Union The rise of Internet Autism Network International National Alliance for Autism Research The Looping Effects of Human Kinds, by Ian Hacking Thinking in Pictures, by Temple Grandin Cure Autism Now Foundation Autism Genetic Resource Exchange Books by David Healy Neurodiversity Institute for the Study of the Neurologically Typical Thoughts on Finding Myself Differently Brained, by Jane Meyerding Functional Neuroimaging Studies of Depression: The Anatomy of Melancholia, by Wayne Drevets Why I Dislike 'Person First' Language, by Jim Sinclair Why Can’t You Be Normal for Once in Your Life? by Judy Singer Of Two Minds: An Anthropologist Looks at American Psychiatry, by Tanya Luhrmann Nosologomania: A Disorder of Psychiatry, by Herman van Praag World Health Report A Default Mode of Brain Function, by Raichle et al.
Globalization of Psychiatry
Neuroscience Research Agenda to Guide Development of a Pathophysiologically Based Classification System, by Charney et al. Functional Neuroimaging of Depression, by Erk, Walter and Spitzer Depression: Perspectives from Affective Neuroscience, by Davidson et al. Alterations in Brain and Immune Function Produced by Mindfulness Meditation, by Davidson et al. The Misbehavior of Behaviorists: Ethical Challenges to the Autism-ABA Industry, by Michelle Dawson Petition to the United Nations Acceptance Versus Cure, by Sue Rubin A Mother's Perspective, by Kit Weintraub The bio-bio-bio model of madness, by John Read Deep Brain Stimulation for Clinical Study of Treatment-Resistant Depression, by Mayberg et al. First Autistic Pride Day Can Brain Scans See Depression?, by Benedict Carey Autism at the Crossroads: Determining the Phenotype Matters for Neuroscience, by Tony Charman Voices From The Spectrum, by Ariel and Naseef On Our Own Terms: Emerging Autistic Culture, by Martijn Dekker Autism Movement Seeks Acceptance, Not Cures, by Joseph Shapiro A New Look at the Neural Diathesis-Stress Model of Schizophrenia, by Jones and Fernyhough Bipolar Expeditions: Mania and Depression in American Culture, by Emily Martin Global Mental Health Movement (GMH) Light and Dark: Correcting the Balance, by Judy Singer Defining the Neural Circuitry of Depression: Towards a New Nosology with Therapeutic Implications, by Helen Mayberg Orchestrating Voices: Autism, Identity, and the Power of Discourse, by Nancy Bagatell Can Neuroscience be integrated into the DSM-V?, by Steven Hyman Mental Health Gap Action Programme (mhGAP) Research Domain Criteria (RDoC), a National Institute of Mental Health initiative Biological Vulnerability of Depression, by Nantel-Vivier and Pihl Neuroimaging and Depression: Current Status and Unresolved Issues, by Gotlib and Hamilton A glimmer of light for neuropsychiatric disorders, by Steven Hyman Major Depressive Disorder and White Matter Abnormalities: A Diffusion Tensor Imaging Study with Tract-Based Spatial Statistics, by Kieseppä et al. Lack of evidence of causality in depression Identity Politics and the Language Controversy, by Dora Raymaker Biomarkers in Psychiatry: Promises and Perils in the Real World, by Ilina Singh and Nikolas Rose Major Depressive Disorder: 2nd leading cause of disability worldwide How It Is Not ‘Just Like Diabetes’: Mental Disorders and the Moral Psychologist, by Nomy Arpaly Aspergia The pharmaceutical industry's turn: from medication to genetics The Pharma-Psych Nexus Structural Neuroimaging Studies in Major Depressive Disorder: Meta-analysis and Comparison with Bipolar Disorder, by Kempton et al. The Genetic Blueprint of Major Depressive Disorder: Contributions of Imaging Genetics Studies, by Scharinger et al. In Search of Biomarkers for Autism: Scientific, Social, and Ethical Challenges, by Walsh et al. The Epigenetics Revolution, by Nessa Carey Antipsychotics: Is It Time to Introduce Patient Choice?, by Morrison et al. Myth: Reframing Mental Illness as a ‘Brain Disease’ Reduces Stigma, by Joanna Cheek A Systematic Review of Resting-State Functional-MRI Studies in Major Depression, by Wang et al. The Book of Woe, by Gary Greenberg Classification of Depressive Disorders, by Philip J. Cowen The search for treatment-specific biomarkers Hopes for diagnostic based on identified biomarkers Neuro: The New Brain Sciences and the Management of the Mind, by Rose and Abi-Rached How Everyone Became Depressed: The Rise and Fall of the Nervous Breakdown, by Edward Shorter Brain Scans Could Become EKGs for Mental Disorders, by Roxanne Khamsi Concentrating on Kindness, an article on Science Mag Neuroimaging and Psychiatry: The Long Road from Bench to Bedside, by Helen Mayberg The Neurobiology of Meditation and Mindfulness, by Tobias Esch Is the Agenda for Global Mental Health a Form of Cultural Imperialism?, by Gavin Miller Connecting the Dots: A Review of Resting Connectivity MRI Studies in Attention Deficit/Hyperactivity Disorder, by Posner, Park, and Wang Most recent edition of the Handbook of Depression Is Evidence-based Psychiatry Ethical?, by Mona Gupta Melancholia: The Western Malady, by Matthew Bell
Sketches by Boz, by Charles Dickens Jane Eyre, by Charlotte Brontë The Tenant of Wildfell Hall, by Anne Brontë Shirley, by Charlotte Brontë David Copperfield, by Charles Dickens Villette, by Charlotte Brontë Bleak House, by Charles Dickens The Professor, by Charlotte Brontë The Lifted Veil, by George Eliot Great Expectations, by Charles Dickens The Strange Case of Dr. Jekyll and Mr. Hyde, by Robert L. Stevenson The Legacy of Cain, by Wilkie Collins Tess of the d’Urbervilles, by Thomas Hardy Dracula, by Bram Stoker Heart of a Dog, by Mikhail Bulgakov Professor Dowell’s Head, by Alexander Belyaev The World, the Flesh, and the Devil, by J.D. Bernal Donovan's Brain, by Curt Siodmak ¿A dónde van los cefalomos? by Ángel Arango Odd Corners, by William Hjortsberg The Terminal Man, by Michael Crichton Asleep in the Sun, by Adolfo Bioy Casares A Scanner Darkly, by Philip K. Dick The Making of Mind: A Personal Account of Soviet Psychology, by Alexander Luria Antecessors of Neuro Lit Crit Reason, Truth, and History, by Hilary Putnam Neuromancer, by William Gibson Schismatrix, by Bruce Sterling The Man Who Mistook His Wife for a Hat and Other Clinical Tales, by Oliver Sacks Mindplayers, by Pat Cadigan When Gravity Fails, by George Alec Effinger A Fire in the Sun, by George Alec Effinger The Exile Kiss, by George Alec Effinger Fools, by Pat Cadigan The Turing Option, by Harry Harrison and Marvin Minsky Galatea 2.2, by Richard Powers Descartes' Error, by Antonio Damasio Enduring Love, by Ian McEwan Albrick's Gold, by Simon LeVay Motherless Brooklyn, by Jonathan Lethem Thinks... by David Lodge The Corrections, by Jonathan Franzen The Epistemology of Cognitive Literary Studies, by Elizabeth Hart Adjusting the Frame, Comments on Cognitivism and Literature, by Adler and Gross Mind Catcher, by John Darnton My Father's Brain, by Jonathan Franzen Darwin and Derrida: Cognitive Literary Theory as a Species of Post-Structuralism, by Ellen Spolsky Into the Silent Land: Travels in Neuropsychology, by Paul Broks The Curious Incident of the Dog in the Night-Time, by Mark Haddon Saturday, by Ian McEwan The Echomaker, by Richard Powers Observe the Neurones. Between, Above and Below John Donne, by Antonia Byatt Proust Was a Neuroscientist, by Jonah Lehrer Atmospheric Disturbances, by Rivka Galchen Neuroesthetics, Neuroscientific Theory, and Illustration from the Arts, by Suzanne Nalbantian Consciousness as Content: Neuronarratives and the Redemption of Fiction, by Gary Johnson Lowboy, by John Wray The Rise of the Neuronovel, by Marco Roth Next Big Thing in English: Knowing They Know That You Know, by Patricia Cohen How Is the Selective Nature of Memory Explored by Ian McEwan and in Biology? by Imogen Ash This Is Your Brain on Jane Austen, and Stanford Researchers Are Taking Notes, by Corrie Goldman Phrenology and Physiognomy in Victorian Literature, by Boshears and Whitaker
Miracles, Science, and Testimony in Post-Tridentine Saint-Making, by Fernando Vidal Brainhood, Anthropological Figure of Modernity, by Fernando Vidal Ectobrains in the movies, chapter by Fernando Vidal in William Tronzo's book The Fragment: An Incomplete History The Moral Authority of Nature, edited by Lorraine Daston and Fernando Vidal Neurocultures: Glimpses Into an Expanding Universe, by Fernando Vidal and Francisco Ortega The Sciences of the Soul: The Early Modern Origins of Psychology, by Fernando Vidal La neuroesthétique, un esthétisme scientiste, an article by Fernando Vidal Are there Neural Correlates of Depression?, book chapter by Fernando Vidal and Francisco Ortega Neuroaesthetics: Getting Rid of Art and Beauty, reviewed article by Fernando Vidal L'expérience mélancolique au regard de la critique, an afterword by Fernando Vidal Prospero Lambertini's On the Imagination and Its Powers, by Fernando Vidal La vue d'ensemble délivre de l'inquiétude: notes sur un thème starobinskien, by Fernando Vidal Corporeality, Medical Technologies and Contemporary Culture, a book by Francisco Ortega Critical autism studies: exploring epistemic dialogues and intersections, challenging dominant understandings of autism The Biopolitics of Autism in Brazil, book chapter by Francisco Ortega, Rafaela Zorzanelli and Clarice Rios Being Brains: Making The Cerebral Subject, by Fernando Vidal and Francisco Ortega Academic and professional tensions and debates around ADHD in Brazil, book chapter by Francisco Ortega, Rafaela Zorzanelli and Valeria Portugal Phenomenology of the Locked-In Syndrome: an Overview and Some Suggestions, an article by Vidal Neurociências: Não somos o nosso cérebro?, a talk by Ortega Brazilian edition of Being Brains