The invention of the individual
My struggles to outthink the deep problems around conceptualizing mental disorders associated with the practice of psychiatry and psychotherapy (I distinguish these fields even though they cascade into each other) took a turn for the dramatic when, in 2008, I began my training as a clinical psychologist in Enugu. Like any other intern, my task was to familiarize myself with the incredibly detailed compendium of mental disturbances, wherein, it seemed, every sort of behavioural anomaly had been classified. It was our bible – the DSM (the Diagnostic and Statistical Manual of Mental Disorders) manual. It didn’t seem to matter where these predetermined abnormalities played out: the DSM pretended to be this apolitical, ahistorical and accultural exegesis of the mysteries and distortions of inner space. The task of every well-trained clinical psychologist was to wield ‘the bible’ as a force for good – which often meant trying one’s darndest to fit the unwieldiness of reported story and experience into neat blocks of analysis labelled with ‘symptoms’, ‘diagnosis’, ‘prognosis’, and ‘outcomes’.
I might say my faith in my profession started to nosedive when I witnessed ‘brain shock therapy’ or electroconvulsive therapy for the first time: the patient, a depressed woman, strapped down, her mouth filled with protective layers of foam and cotton to reduce the impact of her, her entire body dancing in the bed as courses of electricity streamed to her shaved head, the glassy-eyed distance of her doctors watching her humiliation, and the perfunctory tick on the box to say she had undergone ‘treatment’ – all added to my sense of dismay. I couldn’t bring myself to think that this was the only way to bring healing.
Years later, my inner turmoil – now weaponized by a decolonization, Afrocentric ethos – compelled me to recognize the cultural closedness and colonial undertones of Eurocentric psychology. I sought to substantiate my growing awareness of multiple iterations of illness and wellness by exploring Yoruba indigenous healers. So I went to these men with my understandings of disorders still heavily influenced by the need to categorize, reduce and provide symptomatic/diagnostic exemplification for presented behavioural problems. My deep quest was to find other means of framing the dialogue around wellness or Nigeria’s sorry state of psychiatric healthcare; I hoped to find alternatives to pills and drugs – and perhaps cost-effective herbal remedies that could reduce the burden placed on us by our subservience to the pharmaceutical complex.
None of my questions were however answered in ways that might have satisfied those urges or the biases of hard-boiled clinical professionals. The healers didn’t have diagnostic tools or categorical imperatives or reductionistic labels; their accounts of what goes wrong with people were descriptive, anecdotal and mystical – even poetic. They didn’t speak like doctors. In fact, some of them made up categories just to satisfy my insistence. They openly mocked the use of pills as an absolute remedy, and invited me to consider how pills add to the problem. They made ordinary, socially invisible non-events like releasing flatulence, dropping a fork, passing by a house, or stepping on eyebrow hair, complicit in shaping mental health. They played with notions of spirits, gods, and sentient plants. Slowly, I began to realize that there was much more that was emerging in our interactions; I began to suspect that psychology’s original sin or ‘first crime of reductionism’, so to speak, wasn’t that it had reduced depression to synaptic dormancy, abnormality to chemical imbalances, or awareness to physiological substrates, it was that it had reduced the universe to the ‘individual’. Psychology had helped create an anorexic entity, a curious state of being.
The individual is the genius of conventional psychology, the bride of the nation-state, the unit of the market economy, the obsession of salvific faiths, the recipient of institutionalized education, and the hero of the modern narrative.
(To be continued)