Ashwak Sam Hauter’s “Fright and the Fraying of Community: Medicine, Borders, Saudi Arabia, Yemen” explores the psycho-spiritual dimensions of health and medicine in the geopolitical context of migration between Yemen and Saudi Arabia. This post highlights Hauter's ethnographic fieldwork with Yemeni migrants/refugees hospitalized in a Saudi Arabian Hospital in Jeddah, and their demands for 'afiya (spiritual well-being). It features an interview with the author about her work in Saudi Arabia, the meaning of community in the region, and her reflections on the importance of anticipation for her interlocutors.

Interview

Clara Beccaro: Could you tell us how you came to do research on well-being and the psycho-spiritual dimensions of health in Yemen, and later on in Saudi Arabia?

Ashwak Sam Hauter: This project grew organically from curiosity initially sparked by family summer trips to Yemen throughout my teenage years, where I saw firsthand various developmental projects. I was also struck by foreign named hospitals (such as the Yemeni-German Hospital, which I visited when I was ill one of the summers, the presences of Ruqiya (Quranic cures) centers situated right next to biomedical hospitals, and local herbalists selling Arabic medicine and Ibn Sina’s medicine. This exposure—in addition to conversations about medicine around my family’s dinner table—sparked my interest in questions of wisdom/expertise and in both the similarities and differences in local and global medical practices. My eldest brother was the first in our family to go to college and apply to medical school, and it encouraged me to seek resources such as the Ronald E. McNair program to conduct pre-doctoral research. My McNair mentors, Nate Dumas and James Doucet-Battle, helped me envision myself as someone with the capacity to undergo doctoral studies. What began as macro questions around international development during my undergraduate thesis (sparked by a poster I saw in the Yemen German emergency room that advertised ‘the Wisdom is Yemeni and the expertise is German’) shifted with fieldwork. I found myself formulating questions around relationships between the macro and micro, and scientific traditions (Islamic/Arabic medicine, Prophetic Medicine, evidence-based medicine) and their transmission as I listened ethically to my interlocutors speak of the ways imagination shaped their desires for care, health, wellbeing, medical knowledge, expertise, and the enigma of illness. I found myself thinking with them about how patients and physicians were knotted psychically (uqda) in this relationality, and what secures well-being. As my PhD studies began following the Arab Spring of 2011, I learned that not only were physicians at the forefront of protests, but also that they had to navigate their political engagement in relation to their patients’ demands, desires, and threats of divine damnation. A number of physicians were even murdered. As I returned to these questions and formulations at seminar tables in my PhD program, I felt the need to equip myself with the history of medicine in both the Islamic tradition and European, philosophies of the soul/self, psychoanalysis, and approaches to subjectivity within medical and psychological anthropology. After my qualifying exams in 2015, I was unable to return to Yemen due to the war and had to turn to fieldwork in Amman, Jordan, and Jeddah, Saudi Arabia (Hauter 2020).

CB: In your article, you offer an account of Omar’s life, a Yemeni migrant/refugee hospitalized in Saudi Arabia after experiencing persistent jaundice. Part of what you write about is Omar’s difficulties with accessing care as a migrant/refugee; as well as his fright of soul-fracture were he to be refused care, a fright (faj’a) which “results from the inability to anticipate social relations within a Muslim collective no longer felt to be a community.” I wonder about this relationship between the (Muslim) collective and the community. When discussing “community” with your interlocutors, how was it characterized in relation to the collective? Did you encounter competing, or at least distinct definitions, of what a community is, what it is made of? And if so, what do you make of these tensions?

ASH: There are many wonderful scholars working on how the question of the umma isn’t a new development (i.e. Basit K. Iqbal, Ovamir Anjum, Talal Asad, Amira Mittermaier, just to name a few), who show that Muslims have long recalled “aspects of an early community-centered political vision” (Iqbal 2019, 130; Anjum 2012). They address how the question of translating the umma is different for academics and Muslims. Whereas academics are concerned with translating the concept into social science terms, Muslims are concerned with forming an umma within a world of borders. Now there is a working group known as Ummatics that aspires to examine both. Many of these scholars are responding to questions of whether the umma is an aspiration, a fact, imagined, virtual, an illusion, or ethico-juridical. The concept of the umma has been impacted by the expansions and decline of the Muslim community, but also the historical impact of the proper visions of nation-states and popular sovereignty.

In my fieldsites, one’s commitment to another Muslim within the umma was very much a question as patients inquired and contemplated what ethico-religious practices secures an honest, trustworthy, and good doctor, and how it revolved around the cultivation and reading of their soul vis-à-vis the ‘afiya (spiritual well-being) of both the individual and the community. Most importantly, how does an evaluation of such an internal reading of the soul come about when other markers (institutional, global, state) are what grant license to these medical practitioners? Therefore, when people discussed how they made evaluations of medical staff’s proper ethico-religious conduct and God consciousnesses, they utilized concepts that I trace in my book manuscript, such as ḍamīr (conscience), amana (divine trust), and hads (intuition). They believed that these play a role in securing their ‘afiya which entails both individual and communal wellbeing. At times securing ‘afiya shrinks the scope of the umma to the family and neighborhood, and at times it expands it to the realm of what we call Dar Al Islam (realm of Islam) and beyond. The flow from the individual to the communal and the communal to the individual are not so easily parsed or unidirectional but are meant to ebb and flow. For my interlocutors, being in community required individuals to focus less on their abode (body, house, family) and more on their neighbor, neighborhood, strangers, and fellows in need. The aphorism “the neighbor before the house” (al jar qabl al dar) was constantly invoked. My interlocutors noted that curiosity of, inquiry into, and concern for the desire of others in the community is more important than one’s assumptions about personal wellbeing or what the communal good “should” be. Within the proximity of affinity and intimate relations in community, the wellbeing or ‘afiya of the community entails the question of difference and the differences within the umma.

The psycho-spiritual practices of Omar and my other interlocutors are a means of seeking refuge. Therefore, the deployment of familial bonds, neighborly inquiry, and evaluations of the soul/self became moments of seeking refuge necessitated by the aspirations for the umma.

CB: In your piece, you mostly follow Omar’s journey through a hospital in Jeddah, what led him there and why. However, through your conversations with Omar, we also get an understanding of his cousin Nawfal’s own experiences in the hospital and, likewise, his fears of being rejected by doctors when asking for treatment for his kidney stones. Would you argue that together, through their shared sense of faj’a, Omar and Nawfal are forming what could be called a community of fright? In other words, would you consider the fright of soul-fracture, despite being tied to the “dissolution of the Muslim community,” to be the facilitator of another kind of community for Omar, Nawfal, and others like them? Or rather, the opposite?

ASH: There is a shared sense of fright. We can even say that fright and the fear of fright can create community. Fright comes to be anticipated because of the loss of fear of God in one’s commitment to others in community and their ability to host one another. Omar stresses that his anxiety of being rejected and rebuffed protects him against fright and soul-fracture. In a sense, his groundedness in God, in his practices of cultivating his body, soul, and psyche, and by wielding his imagination against the uncertainties ahead, allows him to keep fright at bay. The umma becomes enacted as Omar exclaims that it is ‘aib (indecent) to turn away a fellow Muslim in need.

CB: From my understanding, anticipation is integral to the feeling of fright, but there seems to be at least two kinds of anticipation in Omar and Nawfal’s narratives. On one hand, anticipation as the impossibility to imagine (social relations, for example) and, on the other, anticipation as a kind of over certainty (of a forthcoming lack of hospitality). Perhaps the two are related, but could you elaborate on what your interlocutors make of anticipation? Would you define it as an affect, a state, a condition…?

ASH: Anticipation is very important for my interlocutors as part of the work of the imagination and the imaginal in the psychology of the soul-body nexus, which I explored in a previous publication on Islamic medicine and theories of psychic pain (Hauter 2020). In my work, I use the word anticipation to speak to my interlocutors’ caution against soul-fracture. Anticipation in Arabic can be understood as tawaqa’ or hads. Tawaqa’ (expect/anticipate) literally means to deal with a situation that falls on your lap. Hads is a term coined by Ibn Sina relating to intuition and the work of the imagination. I am reticent to call anticipation an affect or a state, but follow my interlocutors’ designation of them as functions of the imagination (a faculty of the nafs). Functions such as hads and estimation, another inner sense invented by Ibn Sina that cautions you against harm, are cultivated by putting the imagination to work in order to cultivate a priori and accumulated knowledge. The imagination is heavily theorized in Islamic medicine, philosophy, kalam, Sufism, and prophetic tradition as an integral faculty of the soul.

In this article, I was adamant to stress that the fear of soul-fracture itself serves as a protective, the wielding of the imagination, which Nawfal describes as invasion of incessant and obsessing thoughts, in order to prevent its spontaneous unraveling. That very unraveling of the self/soul affects both one’s psyche and appetence as Nawfal describes the need to “return to yourself in order to eat and feel better.” There are both psychic and physiological effects here. Understanding the power of the imagination puts anticipation to work as a buffer between one’s estimation of the uncertainties ahead and the realization of the loss of hospitality. These techniques or practices of cultivating the soul through the honing of the imagination is predicated on this intricate history of exploration of the psychology of the body-soul in the vast Islamic tradition.

It was important to me to trace the ways both Omar and his cousin Nawfal spoke of degrees of fear and fright, and their relation to desire and the nafs (self/soul). This in turn led me to explore fear/fright/anticipation in Sufism, particularly in the work of Imam Alghazali and others who write on the nafs and desire. One anticipates being rebuffed (over-certainty) and one anticipates the impossibility to imagine social relations due to the lack of prior knowledge of such established relationships, or prior knowledge of lack of hospitality. There are both conscious and unconscious structures at play that reify whether an individual who looks like them can move and comport themselves in spaces in a way that is receivable and affirmed. What Omar stresses is the impact of the impoverished image of the Yemeni within the umma on his nafs (soul/self/psyche) that becomes realized when he is rejected, which will impact his capacity to desire/demand/request and when fellow Muslims fail to tend to one another in community.

CB: Finally, your ethnographic work is deeply concerned with what you describe as the effects of “geopolitics on the psyche.” In 1988, Michel Rolph-Trouillot wrote extensively about the necessity of taking the unit of the village in order to make light of global politics. Later on, Vanessa Agard-Jones built on Trouillot’s legacy to consider the body as “a key scalar site at which we might understand a central iteration of global power” (2013, 182). What made you scale even further down—to the psyche—to understand larger dynamics of power? And, inversely, would you say that the psyche has the ability to affect geopolitics?

ASH: The contributions of these two scholars are noteworthy. I see my work resonating with both because they raise the question of relationality between the macro and the micro in the movement of scaling down. In my article, there are movements between the body-soul, psyche-appetence, and geopolitics-psycho-spiritual borders. This relationality can be traced historically to the ways that cultivating one’s soul and body was modeled after the motions of the heavens in the Greek and the Abrahamic traditions, which Remi Brague (2003) beautiful traces in Wisdom of the World.

In terms of geopolitics and psycho-spiritual borders, Omar ties his jaundice to fear of fright/soul-fracture, which we can view as the repetition of the body’s enactment of the excess of geopolitical restrictions that requires others to make space for his desire to be heard by circumscribing their own transgressions. What we learn from Omar is that navigating a landscape, institutions, people, conscious enactments, and unconscious projections once he had crossed a border is less about physical safety than it is about his reception by others and perceptions that others like him can move their bodies through these spaces. It is precisely his anxiety around the fear of soul-fracture that maintains his psychic boundaries. Protecting his psyche against soul-fracture is a psycho-spiritual practice against geopolitical oppression. The transgression here is the loss of the fear of God in shirking one’s responsibilities to attend to the dire needs of other fellows in community in order to secure individual and communal ‘afiya. As geopolitics are transforming Muslim’s spiritual, political, and social commitments, Omar turned to psycho-spiritual practices to protect his psyche.

Since Omar takes refuge by honing his imagination by way of anticipating rejection, he grounded his critique in the loss of fear of God in order to rethink the impact of borders on the Muslim community. Working with my interlocutors—both medical staff (faced with imaginaries projected onto them globally, historically, and spiritually) and patients—forced me to reckon with the question of how your community imagines you. Therefore, reimagining the image of the Yemeni as part of the umma, which I reflect on in a recent article, leads to demands that call on others to recognize the desires of fellow Muslims, placing into question national affiliations and borders by reconstructing those very borders around the concerns of the community (Hauter 2023). Psychic wellbeing itself is not the removal of borders but their expansion or recalibration. This reimagining of geopolitics through psychic recalibration is an echo of this very process.

Another reason for the movement in scale between psyche and desire, body and soul/self, and world is in part the result of ethically listening to the ways my interlocutors reflected on how cosmology informs their subjectivity. My interlocutors’ theories of perception, and anticipation is due to vast discourses in the Islamic tradition on the proper cultivation of the soul-body that secures individual and communal wellbeing or ‘afiya but also truth and justice. This is given that the starting point of man is reflected in a soul that is connected to God, the heavens, nature, other individuals, and other informal forces. That is the very capacity for the psyche to affect geopolitics. This is how fright can create community across borders.