This paper draws on an ethnography of care for social–emotional differences in middle-class North American childhood to explore the relation between care practices employed by parents of neurodivergent, or neuroatypical, children, and emergent ethics of care. Focusing on a single case of asymmetrical care, that between a mother and a neurodivergent child, I draw on video-recorded interviews as well other ethnographic material to highlight how practices of care emphasizing forms of bodily and emotional connection, and labors of attunement to embodied states and forms of expression, enable shifts in the caretaker’s perception of, and affective orientation toward, embodied states. In doing so, I show how moments of partially shared feeling across bodies (interembodiment) and intercorporeal connections can engender the parent–caretaker’s perception of enhanced intersubjective understanding, and authentic insight into the child’s embodied experience, particularly with regard to anxious and excited states. As such, I describe the caretaker’s perceptual shift from an individualizing evaluation of her child’s “sensory issues” to a relational understanding of “anxiety” as a collaboratively engendered embodied emotional state that can be altered, felt, shared, and alleviated through non-verbal tactile communication. In turn, I argue that it can be seen as a “gift” of ethical self-transformation that has implications for the care of neurodivergent childhood. In doing so, I suggest that such insight engenders care for a neurodivergent “other” that may come closer to preserving the other’s singularity. Moreover, I argue that such insight rejects a stereotyped understanding of embodied neurodivergent selfhood as bounded, brain-based, and impermeable.
Regarding the methodology of ethnopsychiatric research, for example, on the Vietnamese Mo Mường's burial rituals or the health-promoting and healing effects of the Chinese Tujia dances, three different approaches can be distinguished: phenomenological-descriptive methods, hermeneutic-interpretive techniques and studies on underlying mechanisms such as hypnotherapeutic or neuroendocrine dynamics. Since epigenetics has shown that cultural and artistic experiences can influence gene expression and genetic functioning, even across generations, the article argues for greater consideration of epigenetics in medical anthropology and ethnopsychiatry. Epigenetic dynamics can significantly influence health promoting and healing effects of rituals in ethnic traditions and determine an individual's responsiveness to such practices. In this context, the interplay between genetics and epigenetics, various concepts of the collective unconscious, transcultural psychiatry, culturally sensitive arts therapies, and issues of migration and transcultural identities are discussed.
The Flexible Interview for ICD-11 (FLII-11) is a new structured diagnostic interview developed by the World Health Organization (WHO) for diagnosing mental disorders based on the ICD-11's clinical descriptions and diagnostic requirements. The instrument is to be used for India's National Mental Health Survey-2 as the primary assessment instrument for mental health morbidity. This paper outlines the systematic process of culturally adapting the FLII-11 for India. Given India's immense cultural and linguistic diversity, this was deemed a crucial step to ensure a valid and reliable data collection process. Key steps included: preliminary evaluation by experts for language and cultural congruence; ascertaining the adaptation's effectiveness in clinical settings; interim analysis, followed by modifications and retesting; and incorporating feedback from both Indian and international collaborators. It also describes the protocol for translating the instrument into 22 recognized Indian languages, ensuring that it can be administered in each state's language. This project was an international collaboration involving teams from India, South Africa, the UK and the USA. Almost all of the changes made from this study were also incorporated into the current version of the FLII-11, which is being tested in other countries, representing the study's global contribution of the study.
Iraq has endured decades of political instability, war, and social fragmentation that have profoundly affected the nation’s psychological and cultural landscape. The erosion of health infrastructures and the normalization of trauma have produced a population in need not only of medical intervention but also of moral and social repair. While biomedical psychiatry remains indispensable for diagnosis and treatment, it does not by itself fully address the relational, cultural, and ethical dimensions of suffering shaped by prolonged violence. This paper examines how Iraqi medical educators and clinicians perceive the introduction of “Medical and Health Humanities” (MHH) within Iraqi medical education as a culturally grounded complement to scientific training and a possible contribution to professional development and psychosocial repair. Drawing upon a three-round Delphi consensus study (2024–2025) involving twenty-two Iraqi medical educators, clinicians, and humanities scholars, the analysis is informed by a pilot pedagogical implementation of an “English through Medical and Health Humanities” course delivered to first-year medical students at the College of Medicine, Al-Nahrain University (2023–2024), providing an initial applied model of culturally grounded MHH in practice, with illustrative student feedback drawn on as perceptions rather than as outcome measures. Together, these strands investigate perceptions, barriers, and strategies for implementing MHH as part of national post-conflict recovery. Findings reveal an 85
Garbh Sanskar (GS) is an Indian holistic reproductive programme that claims roots in ancient Ayurvedic and yogic traditions while drawing upon contemporary wellness practices and international health policy. GS centres offer breathwork, guided meditation, and counselling to expectant and hopeful couples. This article draws upon interviews with GS practitioners across nine Indian cities to examine how these practitioners use wellness discourses to articulate strategies of individual and national improvement. I argue that GS practitioners seek to interweave soteriological and wellness logics to produce enriched reproductive subjects for a therapeutic vision of nation-building. This project uses wellness to assuage the anxieties of modernity, suggest civilisational exceptionalism, and articulate aspirations for the nation. Together, GS illustrates the emergence of a bio-spiritual therapeutic politics where wellness is part of reproductive governance.
Moral distress has been documented in clinical nursing, but far less attention has been given to morally troubling experiences within academic healthcare settings. This study examines how conflicts between professional values and organizational culture may give rise to moral ambiguity, evolve into moral distress, and contribute to moral injury over time. Guided by a critical, transformative theoretical framework, this longitudinal autoethnography explores these experiences across a 45-year nursing career in academic settings. Data were generated through sustained self-observation and reflexive writing between 2013 and 2023, using thematic analysis, along with external documents for triangulation. The analysis identified three academic scenarios in which concerns related to student safety, tenure standards, and racism created ethically troubling situations. Across these scenarios, moral ambiguity emerged at the intersection of personal values, professional obligations, and institutional expectations. Moral distress developed when actions taken in response to these situations were unsupported, ineffective, institutionally silenced, or professionally costly. Moral injury became visible retrospectively through the enduring emotional, embodied, professional, and financial consequences of these unresolved moral events. Subthemes included faculty incivility and racism. Recognizing this progression changed how these experiences could be understood. What had long been interpreted as personal failure, poor coping, or professional inadequacy could instead be seen as part of a larger moral struggle shaped by organizational culture. This study suggests that moral ambiguity may be an early and often unnamed part of that struggle and that when it remains unresolved or unsupported, it can move into moral distress and, in some circumstances, moral injury. Bringing these experiences into view may help academic nursing better recognize and respond to the moral consequences of institutional life.
At an innovative site of psychiatric crisis care work, dialogically trained clinicians in Berlin, Germany transformed the skills learned from the Open Dialogue approach into a means for building solidarity in the face of precarious health structures. Learning to sit with unknowing and tolerate uncertainty, at first developed as techniques to support clients in crisis, became a way by which these clinicians navigated a shifting and unsteady health insurance landscape. In the face of budgetary restrictions and increased oversight by health insurance companies, which challenged the terms of their work and ethical commitments, they supported each other by reconfiguring the terms of clinical responsibility: they dispersed the authoritative gaze most often cultivated in institutional psychiatry and risk management approaches, and developed a means for attending to the uncertainty of crisis by sharing the burden of unknowing with each other. They did this through their unwavering commitment to working in pairs.
This paper develops a conceptualization of biographical diffraction via a creative autoethnography of climate disaster grief. In January 2025, the Eaton Fire devastated Altadena, California killing 19 people and destroying over 9,000 structures. Among them was my family home. Having lived abroad in Aotearoa New Zealand for 5 years, I return to Altadena after the fire, navigating loss from sites of distance and proximity. Drawing upon Barad’s concept of diffraction and the void, I grapple with the asymmetries of grief, privilege, belonging, and self that emerge with the loss of “home.” To do so, I craft a narrative with audio recordings of my footsteps walking around the debris of the Eaton Fire burn scar. By weaving together sensory vignettes, evocative writing, images, and reflections I consider how climate disaster grief is an embodied and emplaced phenomenon both historically entangled and unequally distributed. I then draw upon cross-cultural learnings to explore how Indigenous knowledge can, and cannot, inform healing of place and self from positions of settler-colonialism. Biographical diffraction is thus presented as a tool for attending to the layered emotional, material, and political dimensions of climate disaster, particularly when “home” becomes an unrecognizable site of trauma, memory, and transformation.
Miscarriage and stillbirth can have lasting adverse effects on the mother and on her subsequent pregnancies. We retrospectively explored the postpartum experiences of women in Pakistan who experienced a prior miscarriage or stillbirth, subsequently conceived, and had symptoms of anxiety in their current pregnancy. We conducted in-depth interviews with 18 pregnant married women ≥18 years old in early to mid-pregnancy ( ≤22 weeks) in Rawalpindi, Pakistan, from September 2021 to June 2022, who scored at least mild ( ≥8) on the anxiety subscale of the Hospital Anxiety and Depression scale, without meeting criteria for Major Depressive Episode on a structured clinical interview, and had at least one prior pregnancy loss. We analyzed interview transcripts using an inductive thematic framework. Self-recrimination for pregnancy loss was common, often enmeshed in stories attributing the pregnancy loss to inappropriate diet or lack of precautions against travel, heavy chores, or other physically demanding tasks. Spirituality appeared in women’s accounts of miscarriage and stillbirth in two ways: as consolatory beliefs about qadar (fate) or as suspicions of nazar (evil eye) resulting from another’s envy. Following pregnancy loss, women described specific responses by family and providers as contributing to their distress (e.g. withholding information about the deceased fetus). Reactions by family and others to the loss were often stigmatizing in that they were perceived by women as reinforcing notions of personal blame for their pregnancy loss. Our findings point to natural targets for preventive psychosocial interventions and the need for postpartum and supportive interpregnancy care after perinatal loss.
This Cultural Case Study examines how self-harm becomes meaningful within particular South Asian moral worlds, drawing on intergenerational family oral histories and autoethnographic reflection spanning Kashmir, Andhra Pradesh, Tehran, and the United States diaspora. Read alongside South Asian ethnographic and clinical scholarship, these narratives show that bodily self-injury can function as a form of situated agency and relational communication when verbal self-assertion is constrained. Building on prior work that interprets suicide and self-harm as gendered forms of communication in South Asia, I focus on the social variability of response: when self-harm compels witnessing and moral recognition, and when it instead meets habituation, ridicule, exhaustion, or strategic inattention. I argue that treating self-harm solely as psychopathology risks misreading its moral and interpersonal stakes and can undermine clinical assessment. A culturally attuned approach requires mapping the moral audiences, relational constraints, and idioms of personhood that structure how suffering becomes legible.
The increasing use of generative AI for emotional support has prompted growing debate about the future of mental health care. This article suggests that such reliance is better understood not simply as a technological shift, but as symptomatic of a wider crisis in the politics of listening. This cultural case study examines the experiences of Lily, a 24-year-old Chinese migrant woman navigating emotional distress across uneven care infrastructures in China and the UK. Drawing on person-centred ethnography, it shows how AI chatbots come to function as provisional sites of care under conditions of precarity, gendered obligation, and moralised endurance. The analysis conceptualises these chatbot interactions as a care-patch: a temporary form of digital holding that emerges where human listening is scarce, delayed, or experienced as burdensome. Rather than treating AI use as a matter of technological adoption, the case situates AI-mediated listening within culturally specific moral relations of obligation and responsibility. In doing so, it reframes therapeutic automation as an index of the erosion of listening as a shared social good and redirects attention to the political and ethical challenge of rebuilding infrastructures of human listening capable of absorbing distress without extracting it, outsourcing it, or returning it as blame.
This paper develops the concept of "palliative obstinacy" to describe situations in which palliative care, rather than alleviating suffering in accordance with the patient's wishes and values, becomes a new form of clinical paternalism at the end of life. Drawing on a case narrated by Elyse Ona Singer and Norma Alicia Ordóñez-Vázquez of a patient with cancer requesting physician-assisted death, the paper argues that some models of palliative care unjustifiably pathologize the desire to die by treating it exclusively as a symptom of untreated suffering, depression, or inadequate care. Building on the analysis by Singer and Ordóñez-Vázquez, the paper examines the paradox whereby palliative care expands certain end-of-life choices while simultaneously rendering others-especially physician-assisted death-morally or conceptually unthinkable. It argues that denying the rationality of some requests for hastened death risks undermining patient autonomy and imposing a singular moral framework concerning suffering and dying. The paper concludes that palliative care and physician-assisted death should be understood as complementary rather than mutually exclusive options within end-of-life care.
How does an English-language pop-psychology term become a commonly used mental health idiom in Japan, decades after its coinage? Based on twenty months of ethnographic fieldwork in Tokyo at Raku-no-Kai, a nonprofit supporting people navigating social withdrawal and related distress, this article traces the local uptake of “Highly Sensitive Person” (HSP) as a vocabulary for narrating vulnerability in everyday life. I argue that HSP functions as an emergent idiom of distress (Nichter, 1981, 2010): a flexible, morally workable language (Myers, 2015) through which people make sensitivity speakable, and at times care-able, without fully submitting to psychiatric diagnosis. Situating HSP within the infrastructures that enabled its spread—digital platforms, self-help publishing, and therapeutic media—I trace the conditions under which sensitivity became newly available as a personal disposition and socially legible form of suffering. The COVID-19 pandemic intensified this process by creating a rare public moment in which strain, withdrawal, and emotional overwhelm became broadly discussable rather than privately borne. Yet HSP’s very looseness also produces friction in clinical encounters, where it can draw people into care while failing to translate cleanly into diagnostic categories. In tracing HSP across peer spaces, media circuits, and the clinic, this article contributes to anthropological debates on idioms of distress, psychiatric legibility, and the contemporary social lives of psychological categories.
This article examines the political abuse of psychiatry in Romania during the Ceaușescu era (1965–1989), analyzing how psychiatric institutions were systematically transformed into instruments of ideological control. Drawing on Securitate archives, victim testimonies, legal documents, and medical reports, this study demonstrates three interconnected dimensions of psychiatric repression: the operational mechanics through which political dissent was pathologized into psychiatric diagnosis; the deployment of medical authority to disguise political persecution as therapeutic intervention; and Romania’s distinctive post-1989 failure of accountability, through which perpetrator structures survived regime change intact. The analysis reveals how complicit psychiatrists wielded diagnostic categories such as “paranoia” and “discordant syndrome” as political code, while institutions inflicted systematic violence masked as treatment. Unlike other post-communist transitions where lustration laws dismantled collaborator networks, Romania’s psychiatric nomenclatura maintained uninterrupted control over professional structures, investigative commissions, and institutional memory. This article contributes to scholarship on medical ethics, state violence, and the weaponization of health care under authoritarian regimes, integrating operational, institutional, and transitional justice perspectives. In doing so, it demonstrates how the fusion of medical authority with security power produced a form of repression uniquely resistant to external scrutiny and post-communist accountability.
This study explores how women make sense of injustice and express revenge fantasies through both visual and narrative forms of expression. Using an interpretative phenomenological approach, the study examines drawings and accompanying narratives from fourteen Muslim women in Kerala, India, an under-researched population within the literature on revenge and coping. The analysis identified four superordinate themes: emotional validation through relational reversal, restoration of moral order through indirect or inevitable justice, reclaiming power through aggression and achievement, and withdrawal, moral reflection, and transformation of response. Findings suggest that revenge fantasies are not uniform or solely driven by aggression. Rather, they reflect a range of psychological processes aimed at restoring balance, agency, and meaning following unjust experiences. Across themes, participants were often not positioned as direct agents of revenge but instead engaged in imagined, symbolic, or internally oriented responses. The integration of drawings and narratives revealed important distinctions in expression: Drawings captured more immediate and affective dimensions, while narratives reflected more structured and socially mediated interpretations. Convergences between modalities indicated clarity in meaning-making, whereas divergences highlighted internal conflict and evolving interpretations. The study contributes to the existing literature by demonstrating the value of combining visual and verbal methods for understanding complex emotional experiences. It also offers preliminary insights into how socio-cultural and religious contexts may shape responses to injustice. Overall, revenge fantasies emerge as dynamic and multifaceted processes that function less as intentions to harm and more as ways of negotiating emotional pain, identity, and psychological balance.
For decades, scholars have critiqued the universalizing assumptions of classic attachment theory—particularly the work of John Bowlby and Mary Ainsworth—arguing for more culturally specific and historically situated frameworks of childhood development. Drawing on twenty months of ethnographic research with mental health professionals in peri-urban Cape Town, South Africa, this article shows how classic attachment theory affects clinical attention in a context of distributed caregiving practices shaped by racialized dispossession, displacement, and economic precarity. The article identifies two modes of attention: a clinical one and a decolonial one. The clinical mode, grounded in classic attachment theory, narrows attention around maternal absence and sensitivity, frames distributed caregiving as deficient, localizes blame in individual caregivers, and produces racialized representations of black communities as inherently “dysfunctional.” The decolonial mode, practiced by counselors who shared their clients’ history of displacement and dispossession, foregrounds structural context as an organizing frame, refuses individualized blame while acknowledging harm, and holds the complexities of endurance alongside generational grief. Because modes of attention are cultivated rather than fixed, tracking them opens a different question: not who to blame, but how one might attend differently.
