A Sudden Shock of Care: An Interview with Aidan Seale-Feldman

A fallen building at the base of a mountain, and a person sitting under a sloping roof alongside a large pile of bricks.
Photo by Aidan Seale-Feldman.

This post builds on the research article “The Work of Disaster: Building Back Otherwise in Post-Earthquake Nepal” by Aidan Seale-Feldman, which was published in the May 2020 issue of the Society’s peer-reviewed journal, Cultural Anthropology.

Lachlan Summers: The research for this article emerged in a shocking way—the Nepal earthquakes of 2015—rather than being part of your original research design. How did you manage such a radical shift? And, thinking of the innumerable graduate students and researchers currently changing their research plans due to Covid-19, what ethical questions did you grapple with when this change happened, and how did you manage them?

Aidan Seale-Feldman: This research emerged in a radical way, out of the rupture of disaster into my fieldwork. After the first earthquake, everything, every action and inaction, became an ethical response. I was living in a rural farming settlement when the first earthquake happened. Soon after, Wenner-Gren contacted me and offered to assist in evacuation. At the same time, a kind of solidarity formed with my adopted family there, a kind of closeness because of having gone through this incredibly intense experience together. During this period, one of the daughters in the family joked with me, saying “you will leave us, you will go back to your country and leave us here to die.” She said this in a kind of joking, smiling way but at the same time it wasn’t a joke at all. I think this comment cuts to the heart of the ethical questions I was grappling with at the time and the ethics of anthropology itself. Do you leave or do you stay? How do you respond? What does it mean to be able to leave, to slip in and out of multiple worlds? And then, the question of safety—is it safer in the village, which was largely self-sustaining, or in Kathmandu? And if I go to Kathmandu will I take precious resources away from others? At the same time, I felt that the disaster made an ethical demand on me, a demand requiring me to respond, to act. Given that I had been conducting research on the ethics and politics of global mental health and the translation of affliction between indigenous and psychiatric worlds in the Himalayas, I found myself positioned to do something with my training in medical and psychological anthropology, that is, to engage theory in praxis. Ultimately, I worked with an organization that I already had been in contact with before the disaster, and developed an amazing collaborative relationship with them thanks to their trust and openness. Looking back, I see now how rare it is to find this kind of openness. It is a privilege to be able to do research in times of disaster, and I think the only way this is possible is through a collaborative and engaged approach.

I was also lucky to have empathic advisors who were willing to talk to me by phone and be emotionally present when I needed it most. This past spring when teaching was interrupted by Covid-19 and we moved classes online in the midst of uncertainty, I found myself vividly re-living this period in Nepal. I was surprised to feel somehow prepared. I tried to be present with and for my students in the same way my advisors were there for me. After the disaster, my advisors encouraged me to follow what was happening on the ground, to expand the scope of my research. It was then that I learned that ethnography, more than any other methodology, requires being open to the world. If there is a strength of ethnographic research it is its flexibility, its ability to constantly shift in relation to everything that is happening around you. To work with and from questions that emerge from the field. I think we should embrace the the uncontrollable aspects of ethnography.

My advice for students and researchers whose work has been interrupted in various ways by the virus is to allow yourself to mourn what may have been lost and may no longer be possible, and then when you gather strength, to embrace the uncertainty and liminality of this period for its potential to generate new critiques, questions, approaches, configurations, and formations of anthropological research which may previously have been unimaginable. Yes, there is a long tradition of digital ethnography that offers important methods for doing virtual fieldwork. At the same time, I think that this could be an opportunity to rethink ethnographic fieldwork itself. This might mean letting go of ethnography as the primary way to create anthropological knowledge for the time being. What if this isn’t a limitation but another opening into a new kind of anthropology, one that is comparable to what Ryan Cecil Jobson (2020, 3) has recently described as the smoke from burning wildfires that can no longer be ignored in the AAA conference room, the smoke that demands anthropology “abandon its liberal suppositions.” My advice right now would be to think with the limitations of the virus and participate in collaborative, engaged, and activist work that contributes to collective projects of liberation and well-being. I see this as a moment that has laid bare the limiting and exclusionary foundations of classical ethnography as individual practice requiring certain kinds of bodies, citizenship, and kinship arrangements to an extent rarely made visible, and further highlighted not only the strengths but the necessity for a collaborative, collective, and decolonizing approach to research at every level.

LS: One of the literatures you’re speaking toward is disaster studies, but I see you departing slightly. You don’t seem to necessarily be focusing on what causes disaster, or what disaster destroys, but what disaster generates. Can you elaborate on where you see your work positioned in relation to disaster studies and how your research enriches these approaches?

ASF: The central focus of my work is the ethics and politics of psychic life in times of disaster—this includes the problematization of mental health in times of crisis, the affective and existential dimensions of disaster, and the transient forms of care that emerge in disaster’s wake. As we know, disaster is never “natural” but always unfolds on uneven terrain shaped by geopolitical and social histories of exclusion that predetermine patterns of vulnerability (Oliver-Smith and Hoffman 1999). In my work I attend to vulnerability and chronic suffering, but I am also interested in the possibilities that accompany the rupture of disaster and the forms of thought that emerge in the destabilization of earth and world. In my book project I bring disaster studies into conversation with both critical phenomenology and debates in the anthropology of ethics and morality, particularly in relation to the question of the ethical demand. Here I take as my point of departure the relation between crisis and critique, and the ways in which a situation, once judged to be in crisis, calls forth and demands critique. As Reinhart Koselleck (1988) pointed out, in ancient Greece, krisis had both a juridical and medical meaning, krisis was a critical juncture requiring judgement, decision, or evaluation, often with life or death consequences. The concept of the work of disaster is meant to dwell in the materiality of ethics, that is, the ways in which a seismic rupture calls forth a response, makes a demand, and produces varying responses to this demand across radically different ethical and political traditions and across radically different worlds.

LS: Some analytic frames in studies of disaster usefully re-temporalize the ostensibly sudden onset of disaster, such as vulnerability (cf. Farmer 2011) and shock (Klein 2007). Studies of shock, for instance, examine how state and NGO responses can prolong and exacerbate disaster after its rupture (cf. Adams 2013). However, you’re showing that that which comes after can define “the before.” Could you elaborate on this insight, and perhaps speculate about how it could be used in studies of other disasters?

ASF: I think due to the temporality of my own research, unfolding in the midst of disaster, my approach reflects my own positionality, being in the midst of something and experiencing its unfolding, as opposed to looking back in time and studying this through memory, or through its traces and afterlives. In this regard, I have been particularly inspired by the work of anthropologists and STS scholars like Adriana Petryna, Kim Fortun, Manuel Tironi, and David Bond who have focused on how responses to disaster produce new forms of knowledge and biopolitical experimentation. I see my work as contributing a study of the potentialities and generativities of disaster, the liminal moments of disruption and rupture in which collective effervescence and communitas can emerge. When Arundhati Roy (2020) said “the pandemic is a portal,” what she meant was that in the radical disruption of the structures and sedimented habits by which we live, there is an opening, and in this opening we find an opportunity to create a new world. The political question is, how can the energy and potential of such moments and ruptures be channeled and directed to support liberation and justice in the long term, as opposed to increased privatization, neoliberal governmentality, mass surveillance, or a return to what was before?

In the current situation a lot of people have talked about the pandemic and its management creating a mental health crisis. We have to ask, crisis for whom? For a lot of people, particularly historically marginalized groups, people who have been targets of state sanctioned brutality and oppression, mental health has always been in crisis. It takes a major event like this to force people with power to pay attention. The question is when there is an opportunity to “build back better,” how is the “better” defined? What structures of care and treatment should be promoted? mHealth (i.e., “mobile health,” or the utilization of mobile devices for health services)? Artificial intelligence–driven chat-bots that replace human psychiatrists and therapists? Given what we know about the reproduction and amplification of inequality in automated decision-making systems this seems like a dangerous direction. If this is a chance to reimagine what mental health care is and could be, I hope that treatment can become more political, more collective, more inclusive, more attuned, more healing, and less disciplinary, normative, and pathologizing—this is something that radical mental health collectives have been experimenting with for a long time.

LS: You highlight that the earthquakes provided an opportunity for actors to make a claim that they knew the way to “build back better”—in this case, it was international NGOs talking in terms of mental health. But I’m interested in the relationship between structure and event here: for the disaster to have provided an opening of this type, there must have been some kind of closure. How did people talk about psychic afflictions prior to the earthquake? Did the disaster provide an opportunity for people to refer to illnesses that had previously been stigmatized, or did it generate new vocabularies for talking about these illnesses?

ASF: A significant part of my research is concerned with the conceptualization of affliction, particularly forms of experience that fall under the diagnostic category of the psychosomatic—variously referred to in Nepal as “conversion disorder” and chopne/bhut-pret lagne, being taken over by ghosts and spirits (Seale-Feldman 2019). The concept of conversion disorder, once known as hysteria, is grounded a psychoanalytic theory of the subject in which unconscious distress is “converted” from the mind to the body through a process of somatization. In my work on conversion disorder and global mental health in Nepal before the disaster, I closely followed the ways in which counselors and psychiatrists worked to transform a relational affliction of ghosts and spirits, chopne/bhut-pret lagne, into an individualized disorder caused by repressed desire and the inability to verbally express emotion, the so-called “pressure cooker” model. That said, this is not the first time that new psychiatric concepts of affliction have been introduced in Nepal.

In my archival work I tracked the problematization of psychic life from the opening of Nepal to development in the 1950s to the present (Seale-Feldman 2020). Psychiatry was introduced to Nepal by foreign-trained Nepali psychiatrists in the 1960s and then further expanded by the United Mission to Nepal (UMN), a Christian INGO, in the early 1980s following the work of the World Health Organization Expert Committee on Mental Health in the mid 1970s. As Ian Harper (2014) has shown, UMN purposefully introduced new illness categories, such as nassako rog, nerve illness, that they thought would make more sense to rural Nepalis. Yet it was really in the wake of the Maoist Insurgency in the mid 2000s that Nepali NGOs for mental health and counselling began to expand in connection to the Movement for Global Mental Health and the popularization of psychosocial interventions in conflict-affected contexts. This is one reason why the case of Nepal is so interesting: it is a place where the emergence of global mental health is also closely connected to the history of the discipline of psychological and medical anthropology and the study of culture, mental health, and ethnopsychiatry. As a result, to examine psychosocial transformations in Nepal is also necessarily to turn the lens onto anthropology itself; its politics, paradigms, and ontological assumptions.

The question of the impact of humanitarian psychosocial interventions on experiences of affliction is important. There have been a lot of critiques by anthropologists arguing that humanitarian mental health interventions introduce concepts like PTSD, and use the treatment of trauma to depoliticize social, historical, and political-economic sources of suffering (Summerfield 1999; Breslau 2000; Fassin 2008; Abramowitz 2010; James 2010; Varma 2016). Yet in my research I found that counselors and clients rarely referred to diagnostic categories. What was introduced were psychotropic drugs of varying availability, which many people have continued to take even five years later, often at great personal cost now that the program sponsorship has ended. In one case, a client had sold animals and livestock to cover the costs of his anti-psychotic medication, which if you have read Radhika Govindrajan’s (2018) book on human–animal relations in the Himalayas, can be comparable to selling a member of the family. Yet the lasting impact of post-disaster humanitarian psychosocial interventions on experiences and conceptualizations of affliction remains an open question, and one that I will be working on next in collaboration with my colleague Serena Bindi.

LS: Your use of critical phenomenology seems to offer texture to the literature on phenomena such as mass hysteria, something about which you’ve written before (Seale-Feldman 2019)—how does your critical phenomenology depart from these works? What does critical phenomenology add to more experiential, subjective forms of phenomenology?

ASF: In many ways critical phenomenology is still being developed. First I should say that phenomenology is not singular, but includes a wide range of approaches. For example, in medical and psychological anthropology, Merleau-Ponty was an early and important reference for studies of embodiment (i.e., Csordas 1990), and yet the phenomenology of perception is one approach among many. That said, while phenomenology is a precise method for tracking objectification, perception, embodiment, subjective experience, intersubjectivity, and ways of being-in-the-world, it is not inherently critical unless it is combined with other critical theoretical and intersectional approaches to power, political economy, racism, patriarchy, colonialism, and biopolitics. Critical phenomenology signals this necessary dimension of critique. This summer I’ve been part of a phenomenology Zoom group organized by Jason Throop that brings together phenomenologically oriented anthropologists and philosophers. Together we’ve been exploring the possibilities and limitations of phenomenology as a method, and trying to collectively work out the meaning of critical phenomenology. Thinking with anthropologists and philosophers like Robert Desjarlais, Jarrett Zigon, Cheryl Mattingly, Jason Throop, Lisa Guenther, Alia Al-Saji, and Sara Ahmed, critical phenomenology is, broadly speaking, a method of tracking objectification, to trace phenomena, perceptions, orientations, experiences, events, and singularities as they emerge and crystalize by way of the unexamined concepts we live by and through which we perceive the world around us. Once we begin to do this we can create possibilities of interrupting objectifications by thinking from elsewhere—thus opening up new ways of being, becoming, and imagining.

In my own work my overarching interest is to extend critical phenomenology from a focus on individual experience to the analysis of conceptualization, relationality, and communal experience. I do this in two ways: through the phenomenology of disaster in which I track the conceptualization of crisis, and through my work on “mass hysteria,” a form of affliction that is not bound within the body of a single individual but instead moves and transfers between bodies and worlds. While the turn to individual experience in the 1990s was an innovative corrective to an anthropology overly focused on analyses of discourse and symbols, in my work I have found a focus on the individual to be a limiting unit of analysis that tends to obscure the interconnectedness, porosity, and relational dimensions of life. I think one of the things that coronavirus has revealed has been an undeniable awareness of how interconnected we are, with each other and with the world.

LS: Your focus is on how NGOs and the humanitarian apparatus (Schuller 2016) implements a politics of the a priori (Zigon 2018), but I’m wondering about what friction exists here. Where is the state in these development projects? How do people respond when they’re left outside of crisis frames?

ASF: “Friction” is a great descriptor. The relation between the humanitarian apparatus and the state assumes various forms: enabling, regulating, partnering, and agonistic (especially in the context of Nepal’s long political history of sovereignty). I can give you one example to make it more concrete. In the Mental Health sub-cluster meetings, one foreign humanitarian who arrived in Nepal to implement a psychosocial intervention program repeatedly spoke about the need to “avoid colonial dependencies and create sustainable infrastructures for mental health.” To me this comment revealed not only her own anxieties about what it was she was doing there, but also illuminated the broader historical links between colonialism, humanitarianism, and global health development that resurface in the context of humanitarian intervention (Fassin 2010; Redfield 2012; Packard 2016). In the meetings, the state was embodied in the presence/absence of state officials and bureaucrats. The language politics of the cluster meetings also reflected this—everything was run in English, except when the ministry official spoke, which was in Nepali. But, if you take a longer view, Nepali NGOs for mental health and counselling funded by donors and global mental health research projects have been working directly with the government for a long time to demonstrate the efficacy of various interventions, trainings, and approaches and encourage their national adoption.

How did people respond when they were left out of crisis frames? In the liberal ethics of humanitarian intervention, crisis is required, as we now know, for care. What is outside of this framing? One day I was walking with Prem, who I open my article with, and we were talking about the disaster. Specifically, I was telling him about something that had been on my mind, that is, why so many people from the United States would leave their country to come and help people in Nepal. When so many people were suffering from the slow death of poverty in the United States, why come to Nepal to help after the disaster? Thinking it over for a moment as we walked along the dusty path in the burning noon-day sun, he turned to me and replied, “Prestige.” In the rural farming community where I lived before and during the disaster, humanitarianism and the frame of crisis was not legible. People were not rushing to help unknown victims in nearby districts and villages. For me, this was the ethnographic moment when humanitarian reason suddenly became strange and unfamiliar, the moment that opened up a different perspective onto the relation between crisis and care.


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