Ajita Chakraborty,My Life as a Psychiatrist: Memoirs and Essays

Reviewed by: Anindya Das, Government Medical College, Haldwani, India

Dr. Ajita Chakraborty is a noted authority in transcultural psychiatry. She was among the first women psychiatrists in India and, after completing her training in the UK, joined the West Bengal Health Services and continued to work there for the rest of her professional career. She did this despite facing difficulties and having better opportunities to work elsewhere. While trained in traditional Western psychiatry, she has campaigned for a culturally sensitive form of mental health practice better suited to patients in India.

This book is comprised of two parts consisting of Dr. Chakraborty’s memoirs and her selected essays. The memoirs are of particular interest because the author’s life has spanned many significant historical moments in contemporary India. These events have influenced her orientation to the practice of clinical psychiatry, as well as her understanding of psychological theories of human personality and the self. This becomes especially clear in reading the selected essays, which were written across the span of her career.

As mentioned in the preface of the book, one of the author’s aims in writing a memoir was to expose some of the barriers she faced while establishing herself in the field of academic psychiatry, primarily due to her gender. Autobiographical writing also serves the purpose of self-discovery, and, in a way, has allowed her to assert herself in ways that she avoided in her working life. Dr. Chakraborty has chosen a simple and direct style of writing, shunning any pretence and revealing her socially engaged self rather than the “technical psychiatric” self. The memoir traverses the themes of her struggle as a woman in a professional world dominated by males, her ambivalence toward ideological issues and academic orientation, and the unconventional ways she found to live her life against the backdrop of conservative Bengali culture going through the flux of change and a turbulent political atmosphere.

Chakraborty organizes her memoirs into a description of her youth, her training abroad, her experiences back in Calcutta and her struggles with the Indian Psychiatric Society (IPS). Though an additional chapter titled “Deconstructing and/or Analysing Myself” raises the expectation of some revealing self-analysis, to this reviewer it seems limited in scope and the word “deconstructing” in the title somewhat misplaced. Yet the author’s “relentless pursuit” of “knowing oneself” is both bold and commendable. Chakraborty uses three different perspectives in her self-analysis: a personality disposition view, a social angle, and finally a psychodynamic perspective to analyze the role of gender. Most of the rest of the memoir section is a chronicle of events and people with whom the author interacted, interspersed with some personal reflections.

The collection of essays (most of which are reprinted from previous publications) provide the theoretical and practical outlines of Chakraborty’s approach to general and transcultural psychiatry. Her cultural formulation of personality and identity draws heavily from existentialism and phenomenology. In her critique of modern psychiatry, she rightly identifies its ideological biases. She invokes Foucauldian insights to show how psychiatry is influenced by Western notions of liberal humanism which are either alien to or have been slow to develop in Eastern societies. She draws a distinction between Western constructions of self characterized as a separate entity, complete in itself, compared to the Indian self which is “essentially bound in a fundamental way to others, family, kin, community, even cosmos” (Chakraborty, 2007, p. 34). She develops this argument further to argue for a form of psychotherapy suited specifically to an Indian population. Her social and cultural critique of Western psychiatric practice is also influenced by post-colonial studies, a formulation that remains rather amorphous in her essay titled “Culture and Colonialism: The Case of Indian Psychiatry.”

The first of the essays, which was a part of a presidential address to the Annual Conference of Indian Psychiatric Society in 1976, talks about the human struggle with values, morality, and ethics. Chakraborty explains these constructs, bringing in concepts from Hindu spirituality and urges her readers to consciously engage with such everyday dilemmas to better define their own perspectives.

Perhaps the most popular work by Chakraborty has been her contribution to the analysis of the culture-specific obsessional state or ritualistic practice of suchi-bai among Bengalis. In addition to describing the cultural origin and developing an understanding of the cultural meaning of this obsessional preoccupation with pollution rules found mostly in Bengali widows, Chakraborty conducted a community-based survey published in the Indian Journal of Psychiatry in 1975, which has been reprinted in this book. Readers interested in social epidemiology will be stimulated by the intriguing analysis of gender with its attended social covariates. “Mental Health of Women in Calcutta: A Reassessment” is an essay carved out of one of the author’s most successful publications, the monograph entitled Social Stress and Mental Health: A Social Psychiatric Field Study of Calcutta (Chakraborty, 1990). In the final chapter, Chakraborty pushes for an indigenous method of psychotherapy focusing on important elements suited for the Indian setting.

The central argument in most of the essays revolves around the importance of culture in the expression of self, identity, and psychopathology. Chakraborty contends that one’s self concept is extremely important for psychotherapy. She redefines psychotherapy as “care of the mind”, drawing from Erna Hoch’s “care of the soul.” She urges us to understand the variations in power differentials in a psychotherapeutic setting, and the differences between Western and Indian contexts in the importance of the family and social interaction for psychotherapy. She proposes a form of “self-psychology” in which the “self involves embodiment with its concomitant consciousness and agency … it includes subjective experience, based on cognition and emotions, as well as unconscious domain” and “relation with others … ” in the immediate and the wider society. The most interesting part of this discussion is her theory of how the contemporary Indian confronts the conflict between maintaining the traditional Indian self alongside the Westernized self through a process of compartmentalization and contextualization (i.e., a context-dependent way of thinking and behaviour). Chakraborty concludes by exhorting mental health professionals to be well versed in such human and social dimensions of health and illness.

Although Chakraborty presents her approach as distinctively Indian, much of it is consistent with the perspectives of discursive psychology, a variant of social constructionism. For example, Potter and Wetherell (1987) claim that identity, subjectivity, and agency are constructed within available personal, familial, social, and cultural discourse, which open up various “interpretive repertoires” making way for a socially emergent self. Thus, people position themselves in a context-dependent manner (with implications for self and subjectivity) achieving inter-subjective meaning in social interaction. This approach differs from the conventional understanding of personality in psychology as a set of stable characteristics that can be tapped through psychometric instruments. Thus, Chakraborty’s claim that her approach to personality reflects an exclusively “Indian way of thinking” is somewhat misleading.

In conclusion, Chakraborty argues that the perception of identity and definition of self is guided by the socially constructed nature of Indian-ness, modernity, and tradition. In the process, however, she reduces the complex phenomenon of social determinants to the influence of colonialism, traditional values, and modern ways of life, disregarding the influence of social position and hierarchy, material deprivation, caste dimensions, religious affiliation, and political trends. Moreover, when considering the “Indian individual and family” one needs to consider the regional differences in these factors which shape personal and social identity.

Overall, the audience for the book seems to be rather limited, primarily due to its unconventional orientation to psychiatry. However, those with an interest in social science, particularly gender issues in professional experience and mental health will get much material for reflection. In addition, the accessible language of the book makes it very readable.