Although Africans were rarely institutionalized because British officials believed someone to be insane for opposing colonialism, anticolonial sentiments were often taken to confirm that a person already deemed to be acting oddly was, indeed, insane (as already suspected) (Sadowsky, 2003 :213).
Sadowsky goes on to offer an additional critique (2003), arguing that the ‘gung-ho’ colonial confidence towards the introduction of the clearly beneficial trappings of ‘civilisation’, such as roads and railways, were expressed with less assurance when it came to mental health provision in the overtly unfamiliar cultural context that colonial Africa represented.
Khanna (2003) draws our attention to the wave of sympathetic protest by French intellectuals, like the existentialist, John Paul Satre, towards France’s often brutal colonisation of Algeria, fuelled in part by the compelling critiques of Fanon. While not denying the existence of probable mental illness in his Algerian patients, Fanon argued that effective treatment for colonised patients were negated when administered by the representatives of the enforcing colonial power. Thus, Fanon articulated the interrelationship between colonialism and madness, likening alienation from one’s cultural roots, to alienation from one’s self (Vaughan, 2007). In discussing Fanon’s ‘searing indictment of psychiatry’ Keller (2007: 4) notes that diagnosed dysfunction by colonial psychiatrists, both British and French, conspicuously failed to contextualise these in relation to macro oppression. Consequently, a more sophisticated analysis is required to understand colonial psychiatry as both a tool of oppression, and as something that could be beneficial, and even conceivably the means of developing emancipatory mechanisms in the geo-political and cultural context (Keller, 2001).
In contrast to these accounts of oppression by invading imperial powers, the convoluted development of mental health treatment in mainland China offers some extraordinary and disturbing insights. In an interesting account by Kam-Shing Yip (2005) we learn that early psychiatric institutions in the late nineteenth century were established by missionaries, firstly in the Guangzhou area. These early initiatives grew, culminating in formal psychiatric training at the Peking Union Medical College in 1932. However, with the demise of the old dynastic order, and the rise of the new People’s Republic of China (PRC) in 1949, a root-and-branch revolution of mental health services saw the complete rejection of Westernised ‘capitalist’ psychiatry. In its stead a more radical authenticised1, rather than indigenised, ‘collective action’ was imposed to combat mental illness, now reinterpreted as an individualistic and deviant alienation from established political ideology. Mental health treatment would involve the re-education of the abnormal individual through laceratingly humiliating and excoriating personal criticism by fellow patients and workmates as treatment led by a class-brother/sister psychiatrist with the correct political credentials (Yip, 2005: 108-9).
Kleinman and Kleinman (1999; 1995; Kleinman, 1995) have produced some powerfully compelling accounts of the embodied, psychosocial trauma wrought by the ordeals of Cultural Revolution on individuals since disabled by visceral, unresolved and somatised distress. Collective societal resolution of the more agonising aspects of the Revolution appears to be evaded by a complicit societal amnesia, despite the otherwise complete social transformation of China towards heavy urbanisation and capitalist entrepreneurialism. Today authenticised, culturally grounded therapies like traditional Chinese medicine and Tai Chi co-exist more easily with ‘Western’ biomedical pharmacology, but psychotherapeutic interventions remain marginalised, despite their apparent utility to alleviate some symptoms of trauma (Yip, 2005).
Colonial psychiatry and anthropology
Sashidharan and Francis (1993) note that the eighteenth century Enlightenment saw not only the development of the new profession of psychiatry but also of theories about race and morbidity. These informed early views of psychiatry and continue, so it is argued, to preoccupy the profession today. The authors assert that while theories of race were traditionally divided into hierarchical relationships, wherein European superiority was contrasted with the inferior, colonised races, these were now recast as theories of deviance revolving around the descendants of former colonised subjects (Sashidharan and Francis, 1993).
In relation to difference and diversity, European observers have long entertained an anthropological interest in regional phenomena and their effects on local Third-World populations. Sadowsky (2003), however, identifies that anthropology as a discipline is itself a product of colonial encounters with new cultures; and that arising from these the concept of cultural relativism has developed.
Cleary and Eaton (1992) and Ong (1995) argue that in Borneo and Malaya anthropology served to aid the efforts of the colonialists in enforcing social control through the categorisation of races. In Sarawak, this led to the eventual segregation of ethnic groups (Cleary and Eaton, 1992). Racial categorisation was also a feature of mainland Malaya under colonial rule; however, the sinister overtone of a eugenics-style agenda at play is questionable. The colonial objectives, articulated in the negotiations for Independence, were to afford ‘inalienable genealogical and geographical right to the land and its fruits to the bumiputera’ to protect their interest from the entrepreunial successes of the tenacious migrants from China and the Indian subcontinent, for example (Baba et al., 2010; Chua, 2007: 271). Despite the ironies of such migration having been encouraged by the colonial authorities in the first place, in order to assist in the development of the economic infrastructure, and to more effectively exploit the resources of the Malayan archipelago, these protective policies were summarily adopted by the new postcolonial government.
The fruitful alliance between anthropology and psychiatry continues, as evidenced, for example, by the renowned work of psychiatrist anthropologist Arthur Kleinman. Emile Kraepelin, for instance, carried out extensive travels in Java and Malaya, noting regional manifestations of mental disorder (McCulloch, 2001). In Sarawak by the mid-twentieth century the position of the ‘Government specialist alienist’ and director of the Sarawak Mental Hospital was filled by Dr. K.E. Schmidt who brought with him from Europe many of the experimental advances in psychiatric therapies prevalent in that period. In addition, throughout most of his career in the region, Schmidt, infected, it would seem, with the true zeal of the stereotypical colonial psychiatrist, was busily engaged in the study of the ethnic and cultural peculiarities amongst patient populations and published widely on that topic (Chiu et al., 1972; Nissom and Schmidt, 1961; Schmidt, 1964; Schmidt, 1967).
In addition, the psychoanalytic tradition drew inspiration from the colonial enterprise where a bi-directional influence of psychological interpretations can be detected. Although Khanna (2003) rightly insists on parochialising the psychoanalytic tradition as located within a specific historical-cultural moment, the penetrating and appropriating objective of colonialism offered, appropriately, a rich source of symbolic terrain to probe. The alien and unknowable quality of Africa was symbolically used by Freud in describing women’s strange sexuality as the ‘dark continent’ in reference to phraseology by the nineteenth century explorer, Henry Morton Stanley (Khanna, 2003: 49). Psychoanalysis was typically preoccupied with the irrational fixations and neuroses of the immature mind, those of children and potentially women and primitive people as well (Khanna, 2003). Transported from Europe, psychoanalysis rooted tentatively in India and there evolved to reproduce a new indigenised interpretation of Freudian analysis, such as in relation to the Oedipal Complex, where it is the father, rather than the son that is castrated; allowing Keller (2001: 303) to make a pointed political commentary on the patriarchy of the British Raj and attitudes towards it. Pathological conditions exerted a fascination for Europeans abroad, but where madness, unlike in Europe, does not appear to have been viewed as a particularly feminised condition, especially if based on the numbers of admitted women to asylum across ethnic boundaries. Accordingly, Laura Stoler, in reference to Edward Said’s analysis of Orientalism, indicates that Asian women preoccupied the fantasies of ‘the imperial voyeur’ in a different context from that which tended to animate the amateur anthropologist of this period (Stoler, 1991: 54). However, as Keller (2001) elucidates, Ernst (2010)
