Abstract
This work aims to rethink the relationship between anthropology and cultural psychiatry from a historical perspective, through reflections on the dynamics of forgetting and remembering in the context of migration. While migrants’ symptoms often bear cultural hallmarks of suffering, they also reveal images of a traumatic history, which resurface in moments of danger, uncertainty, and crisis. I claim these symptoms are allegories of a dispossessed past, and can be interpreted as counter-memories, as “palimpsests” of an eclipsed script. Trauma symptoms keep returning to a collective past, and thus can be considered a particular form of historical consciousness. Psychiatric diagnoses may obscure these counter-memories. In particular, the diagnostic category of posttraumatic stress disorder that is commonly attached to traumatic experiences in current clinical practice recognizes the truth of individual traumatic events, but at the same time contributes to concealing the political, racial, and historical roots of suffering.
Keywords
Spectrality is not difficult to circumscribe, as what makes the present waver. Fredric Jameson (1995, p. 85)
Introduction: Bringing historical and moral imagination into clinical ethnography
In this essay, I argue the need for a specific historical and socioanthropological perspective on some forms of psychiatric suffering and diagnosis. These are preliminary observations; I do not provide an exhaustive discussion of this vast topic, nor of the political epistemology of psychiatric diagnosis and the “masking effect” of many diagnostic labels (such as paranoid psychosis or PTSD), which, by naming one conflict, often obscure a different one. Rather, I reflect upon clinical histories I have encountered during my years of field research, and rethink some problems around the role of race, gender, collective historical trauma, and culture in postcolonial disorders (Del Vecchio-Good, Hyde, Pinto, & Good, 2008). I seek to provide a critical reappraisal of the relation between subaltern studies, literary studies, anthropology, and clinical practice, and offer a new angle on the notion of “cultural competence.”
Cultural and subaltern studies are valuable here for several reasons. First, they clearly define the political stake of culture in the constitution of diasporic identities and “subjects in history” (Hall, 1997). The dialectics between “subject” as a unified entity and subjecthood created in shifting “subject positions” help to explain how culture is a “terrain for producing the constitution of social subjects” (Hall, 1997, p. 291). Cultural and subaltern studies attribute strategic importance to Gramsci’s concept of “hegemony” and to the relation between culture and power (“The question of power is at the heart of his [Gramsci] theorization of culture”; Crehan, 2002, p. 100; see also Gramsci, 1983, pp. 126–132). This allows scrutiny of the impact of psychiatric categories, recognizing them as a peculiar expression of cultural hegemony 1 active in the process of “making up people” (Hacking, 1986, 2007). 2 Lastly, because the contingent and discursive nature of identification processes (Hall, 2000) occupies a central role in these studies, theoretical continuities can be traced between critiques of hegemonic knowledge and representation, between “epistemological” or “epistemic violence” (Mudimbe, 1994; Spivak, 1988) and “subjugated knowledges” (Foucault, 2003), and between the phenomenology of oppression and critiques of colonial psychiatry (de Martino, 1977; Fanon, 2008). These issues are analyzed here in the present-day context of suffering among African migrants in Italy.
Given this conceptual horizon, I advance the need for a wider perspective, able to question historical and symbolic profiles of suffering and encompass traumatic power relationships, past and current (Kirmayer, 2012). Within this perspective, cultural competence is the duty to investigate cultural alterity in detail when faced with unusual idioms of suffering, even if it is “dangerous terrain” (Kidron, 2012), and then move toward a concept of culture able to discern the complex relationships between traumatic pasts, myth production, politics of self, historical imagination, as well as contemporary threats, new conflicts, and individual trajectories. My specific interest is in linking this perspective with migrants’ symptoms and how they intertwine cultural idioms of suffering and forms of historical consciousness, revealing concomitantly the internalization of hegemonic forces. This issue intersects with many others, such as refugees and bureaucratic violence (Beneduce, 2015; James, 2012); immigrants and “anti-citizenship technologies” (Inda, 2006); racial bias in clinical settings; 3 medicalization and psychologization of social suffering and so on.
Symptom as signifier
I began this research in 1989, prompted by a patient diagnosed as schizophrenic at a psychiatric health center. “Vincenzo” (a pseudonym) was a “warchild,” born in 1945 to an Italian mother and an African American soldier, against a backdrop of misery and destitution. 4 Vincenzo’s childhood was plagued by the “soft” racism of a poor neighborhood in Naples. His playmates called him “o bastard nir,” (“Black bastard”). When not loitering around, a bottle of beer in his hand, Vincenzo was at home, surrounded by hallucinations and fighting imaginary wars. His skin color and the gaze of others constantly reminded him who he was and how he had been born. His mother was the only person who dared remain with him during his frequent outbursts of rage. She knew his shouts against invisible enemies were harmless.
One day, caught in crossfire between neighborhood criminal gangs, he was shot. He was taken to the hospital but discharged himself. I met him while doctors were trying to convince him to undergo surgery because the bullet was creating serious knee problems. Vincenzo steadfastly refused. It was as if that bullet filled a painful hole, finally put him in a real battlefield after years spent looking for an absent soldier.
Psychiatry, and psychoanalysis since Freud recognize that patients with psychosis can have nonpsychotic hallucinations (Zwarg, 2002). These may be crucial for our understanding of the disorder (as well as for effective therapy). I became convinced that Vincenzo’s refusal was not just one symptom among others (a so-called “delirious denial of illness”) but a desperate attempt to reclaim through experience a history “endured, but not decided” (de Martino, 1995, p. 111), where questions of race, an unknown father, and the violence of marginality had intertwined in a peculiar way. His symptom reminded me of what Deleuze wrote about delirium: “There is no delirium that does not pass through peoples, races, and tribes and that does not haunt universal history. All delirium is world historical” (1997, p. 229).
I recount this experience with Vincenzo here simply as an example to introduce my research approach, which, drawing heavily on de Martino’s work, 5 explores trajectories of the past in embodied, individual “present” experiences, particularly when these experiences are the fragmented or delirious voices of the oppressed and wretched whose daily experience is “being acted by” the other. Writing about slavery and memory, Argenti and Röschenthaler point to how the past is a “social construct that only emerges referentially and selectively, inevitably formed and transformed by means of re-experience and interpretation” (2006, p. 33).
As will become clear, my aim is to bridge medical anthropology and critical ethno-psychiatry, both of which question the mechanisms of the production of suffering (Pandolfo, 1997; Scheper-Hughes, 1992). Reconstruction of the symbolic and cultural dimensions of suffering and healing is necessary, but I claim we need to go beyond this, as well as beyond the bureaucratic lexicon which tries to order migrants’ experience and the categories of recognition provided by psychiatry, humanitarian agencies, and institutions (Beneduce, 2007).
By approaching the symptom as a fluctuating signifier which cannot be circumscribed, or linked to a single event, I seek here to explore its ghostlike nature, its power to reveal the past and its painful knots. By “past” I mean not just the individual past of the patient, but also the collective, haunting past s/he has inherited. This past we call “history” is a past always confronted when stumbling upon other people’s memories. In this respect, my perspective is fuelled by Derrida’s hauntology: “Haunting is historical, to be sure, but it is not dated, it is never docilely given a date in the chain of presents, day after day, according to the instituted order of a calendar” (1994, p. 4). Taussig’s “history as witchcraft” also applies: “The appropriation of the past is anarchical and rebellious in its rejection of chronology and historical accuracy” (1987, p. 368).
Crucially, a recurring feature of the symptoms I consider is their resistance both to being obliterated and to submitting to psychiatric labeling. They are a form of “counter-memory,” often sitting between myth and history, able to challenge dominant interpretations and diagnostic as well as cultural reductionism, thereby revealing alternatives that have been forgotten or discarded. Lipsitz writes, “counter-memory is a way of remembering and forgetting that starts with the local, the immediate, and the personal” (1990, p. 213). 6 Perhaps where we see mere symptoms are attempts to do exactly that: to make it possible to summon up history and experience? That the rediscovery of forgotten or repressed mythical images can free an experience blocked by political repression and psychotic dissociation? (Taussig, 1987).
This ghostly nature of symptoms, and the specific kind of dissonant, idiosyncratic memory they encapsulate, is thrown into relief by those immigrants who experience suffering and madness in a context of loss and abuse. I consider their experiences paradigmatic because in them we can see, inextricably linked, what is usually considered separately; namely social marginality, paranoid symptoms, racial phobia, violence, an unaccountable “resentment” (Fanon, 2008) of the small pitfalls of daily communication, and an overwhelming feeling of dispossession.
As a Nigerian scholar remarks, “Disconnection is a large, psychological, political, and socio-economic problem for blacks in the twenty-first century” (Ogunyemi, 2002, p. 663). I take this as methodological advice and attempt to convey these dismembered experiences and disconnected memories, starting from the hidden battle that forgotten conflicts and symptoms wage against diagnosis. 7 I ask myself, is it possible to state that subalterns and their bodies remember differently?
K’s war
Some years ago I met a young student from West Africa. 8 He had argued with a professor leading him to quit attending courses, fail exams and be evicted from his university accommodation. His new home was the corridors and basement of the faculty building, where he had been loitering for weeks. Some students helped him with small donations, but K was slowly sliding into a menacing world, where he felt surrounded by indifferent, even hostile, figures and images of death.
We met and he told me a story full of uncertainty, failure, and mistrust. His father, with whom he had broken contact, lived in Europe and had been working as a researcher but lost his job after violently protesting that his data—that he considered the result of his own personal research on DNA—had been stolen. Those data “could have given him the Nobel Prize,” K said.
K told me he was a victim of the same injustice: that the professor who had failed him at the exam did so because “he was intimidated by his knowledge,” and could not bear that “an immigrant” knew more than he did. While he talked he first appeared disengaged, already without hope of being believed, then gloomy and aggressive, apparently unsure I was not part of the same plot.
He had recently lost his mother and the fact that he was unable to go home to attend the funeral had plunged him even deeper into loneliness and bitterness. He spoke unremittingly of being persecuted, just like his father, whose story he took as evidence of the fact that “they did not want an African to win the Nobel Prize.”
It is easy to see a delusional construction in his story, but the suffering of the young student resisted confinement within a diagnosis. That indefinite article— “an immigrant,” “an African,” seemed to underlie a more general problem, and to express his feeling of representing a group (Africans, immigrants, or slaves). But unlike Phillis Wheatley or Frederick Douglass, two former slaves turned writers who were able to narrate their intimate histories and to publicly express that feeling, so making their own freedom (Gates, 1987, 2003), K’s experience had only been voiced in the basement of a faculty building and a psychiatrist’s office.
K felt crushed by the feeling of being nothing more than a problem for his professor and—to quote du Bois—he was haunted by “always looking at one’s self through the eyes of others” (1994, p. 2). He felt threatened by many enemies, tormented by the feeling of being despicable, and devoid of hope that his intelligence and his abilities might be recognized. This evokes the Black medical student whose “delirious intuitions” Fanon describes as the “more ‘prolific moments’” of his psychosis (Fanon, 2008, p. 42; the two concepts were formulated by Dublineau and Lacan, respectively). 9
At the time I did not know of the existence of the “Nobel Prize complex” proposed by the psychoanalyst Helen Tartakoff in the 1960s, and then largely forgotten. According to Tartakoff, American culture generates delusional experiences because of the distance between an idealized success and the means available to achieve it (1966, p. 236). 10 The most common ideas are of two different types: delusions of omnipotence and the firm belief of having special and unique talents. Those affected are obsessed with achieving “ambitious” goals and great social prestige. These individuals are usually gifted intellectually or artistically, but are extremely fragile in the face of disappointment and lack of recognition. 11
What K’s story suggests is that “symptoms,” even when they definitely look like symptoms, should always be considered allegories or “ghosts” (Benjamin, 1998). These ruins of a particular past continually question the present. Because that past does not go away it is unredeemed. Symptoms are lieutenants of an absence, a loss. Patients seem to know this, and therefore end up filling the place left empty by those who came before them, no matter whether it is their own past or not. It may be that our young immigrant’s suffering reveals even more.
In their observations on a Tswana immigrant in a South African psychiatric hospital in the 1970s, the Comaroffs point to an important path toward a new understanding of relationships between symptoms and historical consciousness. The other patients considered him a healer, and the authors tried to look more deeply into his laconic, cryptic speech to reveal any discourse about class struggle, exploitation or racial conflict, but to no avail. What they found were only fragmented images (the hardships of work, the aridity of the soil, a mine he once worked in represented as a tomb). Listening to these tales, however, they realized that they were encountering a peculiar form of “historical consciousness,” a kind of understanding of the present that points to a particular social world: the world of apartheid and racial segregation, epitomized by the ghettoizing institution the man was living in (Comaroff & Comaroff, 1992, pp. 155–160). These tales and fragmented memories constitute inchoate articulations of history and experience, a discursive genre which functions like a drive belt “from the history of society to the history of language” (Bakhtin, 1986, p. 65).
Similarly, this young African immigrant, whose uncertain gaze simultaneously revealed memory of distant conflicts and recent humiliation and trauma, taught me something unique about other kinds of historical consciousness. His experience of racial discrimination, mirroring his father’s, strongly suggests that his whole life story was distorted by the intrusive image of a White man (the professor supposedly intimidated by K’s intelligence), as well as by a blackness with which he could not identify. This is the issue at the heart of Fanon’s work, and of that of other Black psychiatrists. 12
For the Comaroffs, the Tswana miner provided “the most profound lesson about consciousness in rural South Africa.” Similarly, K’s is a cry against the repression of the racial issue in contemporary Italy. His case is significant—he is no elderly Tswana miner in the former land of apartheid, but a young African student in Europe thanks to a scholarship. Moreover, recall that it was as a medical student in Europe that Fanon found himself pointed at by people shouting, “Look! A Negro!” (Fanon, 2008). “I am a Black man,” Fanon repeats incessantly, as if trying to remind himself of this fact: “My shout rings out more violently: I am a nigger, I am a nigger, I am a nigger” (2008, p. 117). Fanon left home for France, but a ghost followed him and it prevented him from forgetting the story of his family, racial prejudice, and his own condition. 13
I often recall Toni Morrison’s words, “Whatever the forays of my imagination, the keeper, whose key tinkled always within earshot, was race” (1997, p. 3). 14 All this indicates that, sometimes, we forget what symptoms repeat hauntingly. We try to confine the “tinkling key” within a psychiatric diagnosis, preferring to believe in a world without spectrality, where symptoms are the simple consequence of unconscious conflicts or objective neurochemical alterations.
This raises another issue, strictly related to the diagnostic categories of psychiatry, concerning the presumed predisposition of Africans or African Americans to feel persecuted, to think of oneself as the victim of social exclusion or hostile attitudes. This predisposition has been described as the expression of a “cultural paranoia” with its own specific features (Field, 1960; Lambo, 1955; Ortigues & Ortigues, 1984; Wintrob, 1968). Let us consider now, in this context, the inevitability that when you feel persecuted, marginalized, because you are African, Black, Immigrant, and so on, even trivial episodes can trigger resentment or an experience of alienation—for example the way a professor looks at you, or the seat next to you is left empty in a crowded train (Marriott, 2007). 15
“Time translates”: Symptoms as palimpsests and the work of delusion
His father said: “Afo-la-be,” touching his down heart. “In the place you have come from, what do they call you?”. Time translates. Tapping his chest, the son answers: “Achille” … AFOLABE Achille. What does the name mean? I have forgotten the one that I gave you. But it was, it seems, many years ago. What does it mean? ACHILLE Well, I too have forgotten. Derek Walcott (1990, p. 137)
De Certeau said that the exorcist and the alienist are not so different: their taxonomies diverge radically, but both believe that there is a form of knowledge capable of naming, and both agree on the need to eliminate “an extraterritoriality of language … a text-off, a writing of alterity” (1988a, p. 247). Naming these uncanny experiences means both translating and containing their threatening speech: exorcist and alienist stubbornly try to (b)order the fragmented language of alterity and replace it with another text. The question is then: is this “alterity” the only way these subjects can appropriate their experience? Is it only through this articulation between the past, myth, and the uncertainties of the present that a traumatic history of violence and dispossession can emerge, like a palimpsest, from beneath other inscriptions and images? 18
On the other hand, as we will see below, the kinds of relationships these women have with their spiritual companions suggest, apart from other psychological or cultural issues, a particular way of asserting their desire for freedom, their sexuality, as well as their ambivalent attitude towards motherhood and family. And, there can be no doubt—their utterances, their mystical experiences, at the same time as claiming their will to be mothers, challenge the Western feminist lexicon.
Vera’s story
Vera was born in Nigeria and grew up with her father’s family, attending school until her father’s death, after which she abandoned education and worked for a French family. When this family left Nigeria Vera remained alone for some years, jobless, before deciding to emigrate. She came to Turin in 2003 through the sex-trafficking circuit that has, for years now, been sending young Nigerian women to northern Italy to work as prostitutes. When I first met her she had recently given birth. In the last weeks of her pregnancy an equivocal event had derailed her life in an unexpected way. After an ultrasound she was told that her child was a boy, and in that precise moment she had her own private apocalypse and fell into an acute psychotic state.
A few months earlier, during a previous ultrasound, the doctors had told her she was expecting a girl. The change raised terrible doubts in her: she shouted at the medical staff, asking who “had stolen” her little girl, put a boy in her place, and why? How could she find her? What name should she now give this “switched baby”?
Vera manifested deep ambivalence towards her baby: refusing to breastfeed him, she accepted him only reluctantly. Eventually she did acknowledge him, but only after weeks of hesitation. She gave him an Italian name and started loving him, apparently proud to be a mother. She never named the father. Very little was known about her either, and most information she gave turned out to be false, including her name and family background.
Her behavior led the psychiatric service to conclude that Vera was unable to care for her baby. Social workers saw her reaction as clear evidence of hostile feelings towards her baby, deep emotional ambivalence, and inability to adequately express “maternal love.” 19 A legal process was initiated to remove her child, which moved into a full-fledged adoption procedure. Meanwhile, Vera’s diagnosis changed from “puerperal psychosis” to “schizophrenic psychosis.”
What was evident was a struggle to “negotiate” the meaning of her motherhood and of a baby born from a “client” in conditions often described in current literature as a modern form of slavery. In court, clinicians working at the Frantz Fanon Center produced rich documentation to illustrate the string of traumatic events she had endured in Italy (including being thrown out of a moving car by a client, and a sexual assault when briefly working as a carer in an Italian family. After speaking out about the latter she lost her job).
Not only do these traumas explain her suffering and her ambivalence towards her child (unresolved conflicts are suppressed, suppression generates ambivalence [de Martino, 2005]); they also pointed towards a possible positive prognosis. However, this attempt proved futile, and upon hearing the judge’s decision against her, she suffered a fresh apocalypse. She was acutely depressed, called for her son incessantly, continually asking me whether I could let her see him one last time. She had only one picture of him, which she adored as if it were a religious relic, until one day it mysteriously vanished from her room. Probably stolen to make her “forget him quicker,” one health worker remarked.
Years later Vera never fails to ask at the end of our meetings if the child is healthy, if he goes to school, and is growing up well. After some time she was sent to a psychiatric community, her body irreversibly altered by psychopharmacological drugs, and there she withdrew. She barely spoke, wrote disjointed sentences and nonsense words in notebooks, and would then very carefully sew the pages together, as if she were stitching up a wound, or as if she were trying to hide a secret.
It took a long time for Vera to smile and talk again, and reveal her sweetness and sense of irony. During a remarkably intense meeting, while she was talking about her fear of going to swimming pools, she confessed to me that she was an Ogbanje child.
20
A common trait among Ogbanje persons and adepts of the Mami Wata cult is a difficult and ambivalent relationship with the aquatic in any form, because of the fear that the spirits that live in water might capture and drown them. Familiar to many non-African readers from the character of Ezinma in Achebe’s Things Fall Apart, the idea of Ogbanje can be roughly compared to that of “changeling” in European culture.
21
“When I arrived in Turin,” Vera whispered, the other Nigerian women I met at the market recognized me; they said to me ‘you are an Ogbanje.’ This hurt me, as it hurt me when I was a child, in my country, and my classmates would say it all the time.
The word Ogbanje has marked her since birth, accompanied her through her childhood, and rings out again years later on the streets of Turin. It measures her days, marked by uncertainty and pain caused by the separation from her son; it comes back to haunt her during her lonely nights. What does this ghost of death and absence ask of her? When I think of Vera, I cannot but compare her experience with the apocalyptic world of Sethe, the protagonist of Morrison’s famous novel, Beloved, their common dismembered experience, and their only concern: “beating back the past” (T. Morrison, 2005, p. 86).
Esther’s story
Esther has a very different story, but they share one fundamental feature—she too came to Turin from Nigeria through the sex trafficking circuit and knew the dark experience of dependence and exploitation. She fell into a state of confusion after deciding not to finish paying off the debt to her madam, a debt incurred in order to come to Italy. She knew her refusal could expose her to dramatic consequences (madness, illness, problems with her family back home). Esther fell into a state of anxiety so acute that she was admitted to a psychiatric ward. She was released some days later with a diagnosis of “acute psychotic delusion,” recovered quickly and, with the help of social services, managed to find a job.
She went on to have a baby, Matteo, from a relationship with an Italian man. The father acknowledged him, but some months later became indifferent. The relationship with Esther deteriorated, and he was often verbally and physically abusive. During their frequent quarrels he often said, “You are a primitive! … Negro bitch!” Esther was forced to leave home with the baby, and gave up on her dream of marrying an Italian man and having a “normal” life.
Over the years Esther had several bouts of depression but she always managed, despite the difficulties, to function as a mother. She was alone though, dependent on social services and labeled with several diagnoses from different psychiatrists (adjustment disorder, serious PTSD, and so on). She found herself inside a devilish mechanism, caught in a never-ending cycle of debt and subjugation.
The relationship between Esther and her son was particularly fragile as it was impossible for the child to identify with his mother: an African mother, despised by his father, a mother he was ashamed of being seen with. The violence of racial and social representation made any identification impossible: in Turin, to be a Nigerian woman means to be or have been a prostitute. 22 Here we recognize a well-known issue: the difficulties of the self-identification process in Black children, so famously described by Kenneth and Mamie Clark (1940), and, later, with similar findings, by Fanon (2008) and Hickling (1999).
I remember one meeting when the child, then 9 years old, confessed: “I don’t understand her when she talks, she talks funny, she talks alone.” Matteo was telling about times when found his mother talking or singing to herself in Edo. The child increasingly behaved in demanding and aggressive ways towards his mother, the target—by now largely passive—of his anxieties and demands.
I wondered, over the years, about the relationship between Esther and language. Esther did not communicate well in Italian and, more significantly, even her mother tongue, Edo, seemed to deteriorate over the years. I spent a lot of time trying to make her remember her Edo name, but she seemed to have problems communicating, even using an interpreter who hailed from her hometown. Sentences were left hanging and conversation was tiring. Esther was unable to reconcile the two worlds, to locate herself in a place untouched by feelings of hostility or contempt. Was this amnesia of her own mother tongue the most painful sign of her failure?
I often thought about Sapphire and Toni Morrison. Both authors use the same narrative trick to convey the pain of their protagonist; a world in pieces is represented by “impossible” writing, which is painful to read. In The Bluest Eye several chapters are introduced by long strings of words with no spaces between them. 23 There are no more spaces between words in Pecola’s collapsed world. Morrison’s sentences, and Esther’s speech, look like the perfect metaphor for the final collapse of signifier and signified, a heap of words/ruins where recent failures, the violence inflicted on the bodies of these women, and the traumas of a distant past, are found side by side. In the case of Precious, the protagonist of Sapphire’s story (1997), a painful learning experience under the guidance of a loving teacher allows her to rebuild her life, reclaim her own sovereignty, make herself a subject again. Hers is a “writing of the disaster” (Blanchot, 1986). This very writing makes it possible for her to do what Pecola (and Vera) cannot: to escape from madness, to reconstitute intersubjectivity.
During one meeting, after I had asked Esther whether she at least spoke Edo when she called her family in Nigeria, she confessed that she had been an adept of Mami Wata when she was in Nigeria, that she often woke up anxious because during the night her “spiritual husband had visited her.” As in the case of K, to understand the meaning of these experiences, these painful memories, these images surfacing from underground, we need to free ourselves from any compulsive diagnostic requirement.
Symptoms as cultural archives and palimpsests
The trauma these tales talk about consists of many traumas, and the pain of these narratives is situated in a prodigious layering of painful images. These narratives and images taunt our clinical epistemology because they compromise the uniqueness of meaning and time. Vera’s and Esther’s spirits are certainly not simple flashbacks and traumatic dreams: they are embodied cultural archives, a kind of “verbal relic” and “world’s debris” (de Certeau, 1988b, p. 107) that defies the label of mere “beliefs” 24 or “cultural idioms.” They can only hold meaning within a different kind of cultural competence, one able to question the cultural and historical imagination, a form of cultural competence able to “historically articulate the past,” not in the sense of what “it really was” but by capturing “a memory as it flashes up at a moment of danger” (Benjamin, 1969, p. 255). This is the way in which subalterns remember, and we can recognize it only when we see in their senseless words a “way to tend to the past” (Clifton cited in Rody, 1995).
But why are these notions (Ogbanje, Abiku and so on) “commonplace in West Africa?” wonders Ogunyemi (2002, p. 663). What are these spirits traces of, these elusive figures of deceit, death, and vagrancy? What makes these symptoms similar to a compulsion, the compulsion to remember? 25
Ghosts come from the past, so to this past we have to turn. It is manifestly wrong to reduce the issue of Ogbanje/Abiku persons to a generational conflict, or to speculate about increased risk of schizophrenia in children that have been recognized as Ogbanje/Abiku, as proposed by Ilechukwu (1990–1991). What we need is “another sociology” (Gordon, 1997, p. 147) and, with it, another psychiatry, in order to be able to recognize in this peculiar “clot” of history and experience—composed of symptoms and tales, echoes of family and social violence, of questions, of nostalgia, of loss—a cry for help, an attempt to break free of the menaces of the present. Ogunyemi (2002) offers a precious inroad, a means to think from a different perspective about the suffering of these women and the scraps of myth and religious experience displayed in their symptoms and discourses: The Ogbanje is the trope of migrations, thereby disquietingly scrutinizing the lack of social mobility of her constituency in the living world. She is the bridge between the call and its response, the prayer and the fulfillment of desire. As a people’s nostalgia reinforces their resentment at being displaced, the promiscuous transmigrations and fugitive status of ogbanje become a given. Itinerancy, with its perennial search for another place for security, is the destiny of ogbanje, as it is of black peoples, if West African restlessness and the makings of a diaspora are proof of the desire for survival. The global implications date back to slavery and colonialism with their increase of forced, migratory patterns. (2002, p. 666)
These spirits are literal metaphors of forced migrations, 26 traumatic separations, unspeakable collusions, and at the same time ambivalent desires (the desire for economic autonomy, for experience of different worlds, for asserting individual projects and refusal of family constraints and traditional roles). As has been described for other African possession cults (such as bori, trumba, holley horey, hauka; Beneduce, 2016), Ogbanje and Abiku too are transfigured memories of past traumatic events. But in the context of migration the experience of spirit possession cannot produce the same symbolic work operating in the contexts of origin. The reintegration (therapeutic) value de Martino attributed to religion and rituals of possession as “technique[s] for the de-historification of the critical passage,” and “to reintegrate the presence into the History” (1977, p. 663), is difficult to imagine in their case. 27 The work of Pentecostal churches usually only increases anxiety when it “diabolizes” fetishes, spirits, or witchcraft (Meyer, 1999). The experience of Nigerian migrant women in Italy is completely different: clandestinity, betrayal, violence, fraud, and above all the obsession with debts to be paid (Taliani, 2012). A historical drama seems to repeat itself in their lives: the separation from a world full of ambiguity (often it is the families of these women who organize their journeys), the violence they encounter during their passage and/or in Italy, the ambivalent dependence on those who exploit them after having made their emigration possible and, like slavery in the past, the most “terrifying intimacy” (Spiller cited in Gordon, 1997, p. 167).
The spirits that Vera, Esther, and so many other Nigerian women I have interviewed over the years talk about are far from being simple perception or personality disorders. They are fingers pointed at “the things behind the things” (T. Morrison, 2005, p. 45). We can see them and recognize them as the current avatars of other violence and separations. They link traumatic past and traumatic present: spirits of dead children, traces of loss, and at the same time of a stubborn willingness to witness, these spirits speak about a historical as well as an ongoing experience of anxiety, desire, death, and dispossession.
These spirits keep evoking distant traumatic events in subjects whose existences are marked by uncertainty, marginality, and social stigma, they force them to remember. Simultaneously, though, they are also “good to think with.” They can be used to tame modern-day dramas and violence. They are a form of mythical incorporation of history (Burman, 2009; Lambek, 1993; Platt, 2001; Stoller, 1994; Weismantel, 2001) even if, under the classificatory gaze of psychiatry, they risk being interpreted as just an expression of mental disorder. What I propose is a strategy capable of analyzing these individual (not collective-ceremonial) incorporations of the past as traces of historical events, as expressions of present dispossession, and as symptoms all at once.
This is the reason why I suggest these symptoms be considered “palimpsests” or—to paraphrase Bourdieu—expressions of tacit historical knowledge. Vera’s and Esther’s spirits evoke experiences of errancy, violence, and slavery, death, and separation, but also of desire and recognition: they are ghosts in the true meaning of the word, because they continue to haunt their and our presents. As Gordon points out: “social memory is not history, but haunting” (1997, p. 165). Their symptoms bridge incommensurable memories lodged in a collective past of dispossession and an individual present experience of loss and destitution. To all these dramas must be added the unpredictable violence of a bureaucratic system that repeats—often on the basis of psychiatric diagnosis and an exploded, more insidious panopticon within which modern institutions scrutinize the daily lives, gestures, and behaviors of these “imperfect” citizens and mothers—the most dramatic event: separation from one’s children. Why are we surprised that the phrase “new forms of slavery” is commonly deployed today, when we face a scenario that reiterates such painful experiences of dispossession? Why are we shocked when these women shout that Whites want to steal their children? To repeat myself, in these “Black histories” it is difficult if not impossible to separate “the political, the psychological, and the ethnic” (Rody, 1995, p. 95).
According to Gramsci, “the history of subaltern social groups is necessarily fragmented and episodic” (Gramsci, 1977, p. 2283). This enlightens the experience I speak about and allows a further meaning to be grasped in the fractured lives of these women, as well as in episodes of collective malaise often categorized as just “individual, folkloric, pathologic episodes” (Gramsci, 1977, p. 2280). In his analysis of a rebellion in southern Italy, Gramsci insists on the need to counterpoint the hegemonic interpretations that, “isolate the protagonist’s behavior, contenting themselves to write his pathological biography [emphasis added] … For social elites, the members of subaltern social groups always have something of the barbaric or pathological [emphasis added] about them” (1977, p. 2279). 28 From this perspective, the subalterns’ hallucinations and delusions can be interpreted not just as “symptoms” but as painful palimpsests, dismembered memories and “sensory traces” (Hunt, 2008, p. 229) revealing a specific kind of “repetition,” a nervous order of things: the “return of the wretched past, the past which was not chosen” (de Martino, 2005, p. XXI). 29 Their experience, so often reduced to psychiatric labels, speaks of a subjugated memory and knowledge.
This leads me to suggest that the work of their “delusion” reveals both the shadows of a dispossessed past and the internalization of hegemonic discourses: the same internalization as at the basis of their consuming desires, similar to the alienation Fanon describes in Martinique (2008). To accept this means, in my ethnography, the ability to hear their speech without confining their affliction, their broken narratives, 30 and to work with their “delusion” or strange somatic disorder with the awareness that sometimes subalterns cannot speak in any other way—which is different from saying that they cannot speak in any sense, as Spivak (1988) seems to suggest.
Conclusion: A hospitable memory for symptoms
There is really nothing more to say—except why. But since why is difficult to handle, one must take refuge in how.
If symptoms and suffering coalesce around repressed memories, if bodies can remember and incorporate historical and social events (Burton, 2011; Fassin 2007; Kleinman & Kleinman, 1994), I would like to suggest that psychiatric diagnosis itself can be a way to dislocate and repress a socially painful and unspeakable history. This is the case, in my opinion, for PTSD; a diagnosis I find paradigmatic of the classificatory anxieties and perpetual transformations that characterize the history of psychiatry.
Young (1995a) points out that historically the issue of “guilt” was almost absent in analyses of war neuroses, and the discussion concerned, rather, shame, fear, or the clash between different social attitudes. Only after the Vietnam war did the dimension of guilt, linked with the “pleasure” rather than the “necessity” of violence, enter via the notion of PTSD, as a consequence of what is now a characteristic feature of modern warfare: the massacre of civilians (Young, 1995a, p. 126). Caruth writes: “If PTSD must be understood as a pathological symptom, then it is not so much a symptom of the unconscious, as it is a symptom of history. The traumatized, we might say, carry an impossible history within them” (1996, p. 5). But this “impossible” history is also the history of the collective social and political responsibility for causing horror, death, and violence. In other words, this history concerns the history of PTSD diagnosis too. By naming together the pain of the victims and the pain of those who caused that suffering without making any significant distinction, by actively obscuring the reasons of state that made it possible to humiliate, torture, and rape, PTSD buries a history of arbitrariness and impunity. Its social function is clearly that of acquitting necropolitics. The political issues surrounding PTSD diagnosis are a good example of what I earlier called the “concealing side effects” of some psychiatric diagnoses.
In the cases discussed above (K, Vera, and Esther) and in the case of Vietnam veterans (or veterans of other recent “humanitarian” wars) we find the same stubborn wish: they want their suffering to be recognized, of course, but they also want to bear witness, they want “to return to the past.” Their anxiety, their uncertain existence conveys the painful ambivalence of the “witness”: the common, legal definition describes someone who has seen something, and can assert the truth of something because s/he has direct knowledge of the fact; but it can also mean being entrusted by someone else with the memory of a fact that can no longer be seen. This double dimension of the notion of “witness” contains the issue of subjectivity, the ability to assert one’s own position as a subject, one’s agency. This becomes possible only when painful and unspeakable memories can be shared with someone ready to listen. In her discussion of the testimony of Holocaust survivors, Oliver says (referring to Dori Laub): “psychic survival depends on an addressable other. … If the possibility of address is annihilated, that subjectivity is also annihilated” (Oliver, 2001, p. 17).
I think an approach that makes it possible to define what I call the ambivalence of the “witness” (here: suffering people with their symptoms-testimonies of loss), in turn, makes it possible to differently interpret the delusions and hallucinations of these patients. Crucially, it makes it possible to go beyond the mere cultural connotations of their form and meaning; it allows us to see a real testimony in these postcolonial symptoms. This approach entails a different relationship between anthropology, history, and psychiatry, a relationship based on notions such as “historical imagination” (Comaroff & Comaroff, 1992) and “implicit social knowledge” (Taussig, 1987).
By questioning community and parenthood (as well as the ambivalence of kin relationships), by travelling between the place of the dead and the world of the living, symptoms of possession and concepts such as Abiku and Ogbanje bear witness to specific experiences of body, loss, and death. At the same time, they express the suffering of the postcolony, the experience of errancy as well as the will to remember a past of violence. The same happens with PTSD: after all, the flashbacks, the nightmares, the depression, and the “paranoia” of these soldiers, the uncanny nature of their disorders—that the PTSD diagnosis tries in vain to exorcise—are just a return to the present of a repressed past. 31
In this sense, if “to remember too much is, indeed, a form of madness” (Phyllis, 2008, p. 212), I would suggest that this “too much” has to be read as a painful struggle against silence, against the dissimulated displacement provided by the psychiatric labeling gesture, or the invisible repression of the moral enigmas surrounding traumatic experience made possible by those models that reduce the “reasons” of suffering to bad storage of ugly memories (Young, 1995b). Their symptoms do not claim to be “History”: they just remind us that—as expressions of a dismembered memory—they have a moral (as well as political) value. In her analysis of the doll test’s role in fighting the segregated school system in the US, Bergner suggests a similar conclusion: This legal landmark merges with the cultural role of psychology to give us an interpretive frame for racism that is consistent with the “creed of our time,” that is, with the “romance” of American psychology … In other words, we prefer to see our social problems as psychological rather than political, and the doll test facilitates this interpretation. It presents a melodramatic tableau, blending children (the “innocent” victims of racism) and dolls (the quintessential marker of childhood fantasy)—while leaving the perpetrators invisible (and the spectator guiltless). (2009, p. 323; see also Marriott, 2000)
Vera’s and Esther’s ghosts, K’s delusions, with their oblique references to diaspora, racism, contested motherhood, humiliation, and other traumatic memories, are obstinate echoes or traces, that diagnoses as well as historical archives, try in vain to hide, or erase (Boni, 2013). They are echoes that demand to be taken seriously and be listened to, even if remembering can be painful and “unwise” (T. Morrison, 2005, p. 324). 32
Footnotes
Acknowledgements
The research on which the article is based was presented at the Critical Psychiatry and Anthropology Workshop (Panel IV. Trauma and the Experience of Madness), May 17, 2013, Department of Anthropology, University of California, Berkeley. I would like to express my thanks to Anne Lovell, Stefania Pandolfo, Nancy Scheper-Hughes, and the other participants for their comments on the early version of my article. Moreover, I would like to express my gratitude to all who have reviewed and commented on this paper for their insightful remarks and suggestions, as well as Simona Taliani, with whom I have discussed most of the issues presented in this article over the last many years, and Jessica Lerche, for her mindful linguistic revision. But above all I would like to express a profound acknowledgement to Vera and Esther, who accepted to share with me their painful experiences, their sorrow, and their hope.
Funding
The author received no financial support for the research, authorship, and/or publication of this article.