Mental health in the war on terror : culture, science, and statecraft

224 Pages·2015·1.54 MB·English

by  Aggarwal

MENTAL HEALTH IN THE WAR ON TERROR
Mental Health in the War on
Terror
CULTURE, SCIENCE, AND STATECRAFT
Neil Krishan Aggarwal
COLUMBIA UNIVERSITY PRESS NEW YORK
COLUMBIA UNIVERSITY PRESS
Publishers Since 1893
New York Chichester, West Sussex cup.columbia.edu
Copyright © 2015 Columbia University Press All rights reserved E-ISBN 978-0-231-53844-2
Library of Congress Cataloging-in-Publication Data Aggarwal, Neil Krishan, author.
Mental health in the war on terror : culture, science, and statecraft / Neil Krishan Aggarwal.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-231-16664-5 (cloth : alk. paper) — ISBN 978-0-231-53844-2 (e-book) I. Title.
[DNLM: 1. Mental Health—ethnology—United States. 2. Bioethical Issues—United States. 3.
Prisoners of War—psychology—United States. 4. Terrorism—psychology—United States. 5.
Veterans—psychology—United States. WA 305 AA1]
RC451.4.p7
616.890086'97—dc23
2014020991
A Columbia University Press E-book.
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Cover design: Milenda Nan Ok Lee Cover image: © AP Photo/Brennan Linsley References to
websites (URLs) were accurate at the time of writing. Neither the author nor Columbia University
Press is responsible for URLs that may have expired or changed since the manuscript was
prepared.
The question or questions that have to be asked are: “What types of knowledge are you trying to
disqualify when you say that you are a science? What speaking subject, what discursive subject,
what subject of experience and knowledge are you trying to minorize when you begin to say: ‘I
speak this discourse, I am speaking a scientific discourse, and I am a scientist.’ What theoretico-
political vanguard are you trying to put on the throne in order to detach it from all the massive,
circulating, and discontinuous forms that knowledge can take?”
—Michel Foucault, Society Must Be Defended
CONTENTS
PREFACE
ACKNOWLEDGMENTS
CHAPTER ONE
Mental Health, Culture, and Power in the War on Terror
CHAPTER TWO
Bioethics and the Conduct of Mental Health Professionals in the War on Terror
CHAPTER THREE
The Meanings of Symptoms and Services for Guantánamo Detainees
CHAPTER FOUR
Depictions of Arabs and Muslims in Psychodynamic Scholarship
CHAPTER FIVE
Depictions of Suicide Bombers in the Mental Health Scholarship
CHAPTER SIX
Knowledge and Practice in War on Terror Deradicalization Programs
EPILOGUE
NOTES
REFERENCES
INDEX
PREFACE
FOUCAULT’S PENETRATING INSIGHTS INTO THE connections between knowledge
and power, between science and politics, have gripped me since the
declaration of the War on Terror. I entered medical school in 2000 and
watched the 9/11 attacks unfold on live television. As I attended medical
conferences, I began perceiving the creeping influence of politics within
academic discussions: bioethicists debated the philosophical grounds for
torture, and psychiatrists conjectured about the irrational motivations of
suicide bombers. Medical scientists placed certain theoretico-political
vanguards related to national security on the throne of science at this
exceptional moment of American history. What perspectives were
becoming “minorized” and “majorized” in the War on Terror, and how did
these perspectives immortalize cultural values, beliefs, and orientations
as scientific knowledge? In a broad sense, how has the War on Terror
changed medicine, and how has medicine changed the War on Terror?
The goal of this book is to analyze the cultural meanings of mental
health knowledge and practice produced throughout the War on Terror.
My frameworks for studying the interrelationships of mental health,
culture, and power come primarily from cultural psychiatry and medical
anthropology. Central to both disciplines is the tenet that medical
systems are cultural systems with beliefs, behaviors, and meanings
transacted among individuals in social institutions. I aim to show through
a wide array of materials that we can study medical systems in the War
on Terror as cultural systems. These source materials include
government documents; reports and position papers from
nongovernmental organizations; legal files such as charge sheets,
motions, rulings, and transcripts; direct and indirect interviews;
newspaper articles; and scholarly publications. These analyses are not
intended against the mental health system as a whole, and they certainly
do not belong to the antipsychiatry movement. As a psychiatric clinician
and researcher, I have witnessed the healing power of effective
medications and psychotherapy. However, mental health suffers from a
long history of stigma in much of the world. The peculiar cultural
construction of mental health knowledge and practice in response to the
War on Terror may exacerbate this mistrust. This book is not an
exhaustive catalog of mental health knowledge and practice in the War
on Terror, nor is it meant to be polemical or apologetic. On the contrary,
the book takes seriously the idea that mental health routinely faces sharp
challenges from the state. Mental health knowledge lends itself to
conflicts of interest between the individual and society because it is
employed in practice to differentiate normal and abnormal states of being
within society. The state may wish to punish undesirable populations, and
political uses of psychiatry may result when mental health professionals
work uncritically toward state interests.
This book appears at a time when three cultural trends have affected
medicine. First, most attention to mental health in the War on Terror has
centered on bioethical debates. While mental health professionals
involved in coercive interrogations or questionable clinical practices
certainly deserve scrutiny, bioethical violations represent a larger issue of
employing mental health knowledge and practice to advance the goals of
statecraft. Investigating this larger issue is the goal of this book. Second,
cultural psychiatry has typically drawn upon many disciplines—
psychology, sociology, anthropology, and cultural studies—to create a
vibrant specialty that understands mental health and illness in its social
and cultural contexts. The rise of evidence-based medicine has
disqualified ways of knowing and learning aside from large clinical trials.
In my capacity as a psychiatric researcher and educator, I worry that our
trainees ignore the social sciences and humanities, which have much to
teach us about those areas of life, such as birth, death, pain, and
suffering, to which medicine should not lay exclusive claim. Third, the
representation of Muslims and Islam in medical scholarship has often
gone unchecked. Many stereotypes that would not be countenanced for
other groups are willingly tolerated and even promoted. Scholars of
religion and cultural psychiatrists can collaborate to ensure that such
negativity is not disseminated under the guise of science. I hope that this
book will stimulate critical discussions around the cultures of biomedicine
through incisive examinations of its professional literature.
ACKNOWLEDGMENTS
I HAVE INCURRED MANY DEBTS in writing this book. Several people wished me
well throughout its execution. In 2000, Amer Sidani, Rachna Dave, Omer
Bokhari, and Moustafa Banna first suggested that I write. In 2003, Ravjot
Singh Pasricha and Arun Janikaraman encouraged the process. In 2011,
Nimay Mehta told me that he would be the first to purchase the book.
Parvinder Thiara and Luvleen Sidhu supported the book through its end
in 2013. Ricky Shah and Samir Rao helped me consider how to market
the book. Thank you to you all.
My teachers at Sewickley Academy cultivated my love for learning.
Kenneth Goleski, Sira Metzinger, and Karen Coleman helped me
discover a capacity for languages; Larry Hall, Peter Golding, and Ham
Clark encouraged me to question authority through polite but incisive
arguments; Bill Barnes, Joan Reteshka, and Larry Connolly taught me to
write; Vicki Polinko and the late Barbara Salak refined my aesthetic
sense. At Case Western Reserve University, Marie Pierre Le-Hir, Jackie
Nanfito, and Vincent McHale pushed me in supervising my theses.
Atwood Gaines, James Pfeiffer, and Rachel Chapman introduced me to
medical anthropology.
In medical school, Paul Farmer challenged me to think about applying
social theory to clinical medicine and sustained a three-year
correspondence with me as I considered graduate school. Joy Marshall,
Stuart Youngner, and Max Mehlmann encouraged me not to relinquish
my interests in the social and cultural determinants of health. Jerrold Post
exposed me to the intellectual borderlands between psychiatry and
political theory. These rewarding experiences drew me to Harvard
University and my most formidable academic encounters. Early on, Ali
Asani grasped that I would work at the intersection of medicine, social
theory, and South Asian religions. Michael Witzel, Larry McCrea,
Wheeler Thackston, Carl Sharif El-Tobgui, Moustafa Atamnia, Shahab
Ahmed, and Sunil Sharma taught me patiently. Discussions of social