Medications & Psychiatry

 email page    print page

All Topic Reviews
Psychiatry Under the InfluenceAlternatives Beyond PsychiatryAmerican MadnessAmerican PsychosisAn Unquiet MindAntipsychiatryBad PharmaBefore ProzacBetter Than ProzacBiological PsychiatryBipolar, Not So MuchBlack Man in a White CoatBlaming the BrainBrain Science and Psychological DisordersBrainwashedClinical Psychopharmacology Made Ridiculously SimpleComfortably NumbCompassion and Healing in Medicine and SocietyComplete Mental HealthConcise Guide to PsychopharmacologyCrackedCritical PsychiatryCultural FormulationDeconstructing PsychosisDemystifying PsychiatryDiagnosing the Diagnostic and Statistical Manual of Mental DisordersDiagnosis: SchizophreniaDiagnostic Issues in Depression and Generalized Anxiety DisorderDimensional Models of Personality DisordersDisordered Personalities and CrimeDoctoring the MindDoctors of DeceptionDrop the Disorder!DruggedDrugs for LifeEmpirical Ethics in PsychiatryEssential PsychopharmacologyEssential Psychopharmacology of Depression and Bipolar DisorderEssentials of Psychiatric DiagnosisEsssential Philosophy of PsychiatryEthics in PsychiatryEvidence-Based Treatment of Personality DysfunctionExercise-Based Interventions for Mental IllnessFinding the Right Psychiatrist:Forces of HabitHandbook of Clinical Psychopharmacology for TherapistsHappy Pills in AmericaHealing the Soul in the Age of the BrainHelping Parents, Youth, and Teachers Understand Medications for Behavioral and Emotional ProblemsHerbs for the MindHigh PriceHippocrates CriedHistory of Psychiatry and Medical PsychologyHookedHuman TrialsInfectious MadnessInspired SleepIntoxicating MindsIs It Me or My Meds?Let Them Eat ProzacLife-Threatening Effects of Antipsychotic DrugsLitLiving with Bipolar DisorderMad in AmericaMad ScienceMalignant SadnessMedicating ChildrenMedicating Modern AmericaMental Health in Asia and the PacificMind FixersMoments of EngagementMommy I'm Still in HereNatural Healing for DepressionNo One Cares About Crazy PeopleNot CrazyOrdinarily WellOur Daily MedsOverdosed AmericaPathologist of the MindPediatric PsychopharmacologyPediatric PsychopharmacologyPediatric PsychopharmacologyPharmaceutical FreedomPharmacracyPharmageddonPharmageddonPhilosophical Issues in PharmaceuticsPoets on ProzacPower HerbsPowerful MedicinesPrescriptions for the MindProfits Before People?Prozac and the New AntidepressantsProzac As a Way of LifeProzac BacklashProzac DiaryProzac on the CouchPsychiatric DiagnosisPsychiatric HegemonyPsychiatrists and Traditional HealersPsychiatry and EmpirePsychiatry and the Business of MadnessPsychiatry as Cognitive NeurosciencePsychiatry at a GlancePsychiatry in PrisonsPsychiatry ReconsideredPsychopathyPsychopharmacology Problem SolvingPsychotropic Drug Prescriber's Survival GuidePsychotropic Drugs And Popular CulturePsychotropic Drugs: Fast FactsRaising Generation RxRe-Visioning PsychiatryRecovery from SchizophreniaReligious and Spiritual Issues in Psychiatric DiagnosisRitalin NationRunning on RitalinRutter's Child and Adolescent PsychiatrySaving NormalSchizophreniaShock TherapyShock TherapyShould I Medicate My Child?ShrinksSide EffectsSometimes Amazing Things HappenStraight Talk about Psychiatric Medications for KidsSuccessful PsychopharmacologySuffer the ChildrenTaking America Off DrugsTalking Back to ProzacTextbook of Cultural PsychiatryThe $800 Million PillThe Age of AnxietyThe Anti-Depressant Fact BookThe Antidepressant EraThe Antidepressant SolutionThe Antidepressant Survival ProgramThe Big FixThe Book of WoeThe Complete Guide to Herbal MedicinesThe Conceptual Evolution of DSM-5The CorrectionsThe Creation of PsychopharmacologyThe Cult of PharmacologyThe Dream DrugstoreThe Emperor's New DrugsThe Essential Guide to Prescription Drugs 2005The Essential Guide to Prescription Drugs 2006The Making of DSM-III®The Medical Model in Mental HealthThe Medicated ChildThe Medication QuestionThe Merck DruggernautThe Mind/Mood Pill BookThe Natural Pharmacist : Natural Health Bible from the Most Trusted Alternative Health Site in the World The Pill BookThe Pill Book Guide to Natural MedicinesThe PlaceboThe Rise and Fall of the Biopsychosocial ModelThe Sedated SocietyThe Therapist's Guide to PsychopharmacologyThe Therapist's Guide to Psychopharmacology, Revised EditionThe Truth About the Drug CompaniesThe Use and Misuse of Psychiatric DrugsThe World of CaffeineThomas S. SzaszToxic PsychiatryTrouble in MindTry to RememberTry to RememberTwilight of American SanityUnderstanding Physician-Pharmaceutical Industry InteractionsUnhingedVoluntary MadnessWarning: Psychiatry Can Be Hazardous to Your Mental HealthWhat Is Mental Illness?What Psychiatry Left Out of the DSM-5What Works for Whom?Will@epicqwest.comWomen, Madness and MedicineYour Drug May Be Your Problem

Related Topics
Psychiatry and EmpireReview - Psychiatry and Empire
by Sloan Mahone and Megan Vaughan (Editors)
Palgrave Macmillan, 2007
Review by Tony O'Brien, RN, MPhil
Feb 3rd 2009 (Volume 13, Issue 6)

Psychiatry and Empire is part of the Cambridge Imperial and Post-Colonial Studies Series, covering modern imperial history and contemporary issues in the former colonies. According editor Megan Vaughan's introduction, psychiatry has long been considered to more or less unproblematically have functioned as an instrument of colonization, adding scientific and medical authority to the subjugation of colonized peoples. The story is a familiar one. Early settlers paved the way with guns and occupation; the resulting crises of legitimation being addressed by the newly emerging social and medical sciences. Psychiatry is a prime candidate as a tool of colonization, having as it does, the mandate to manage unruly and disruptive members of the community. In this publication the various authors consider the relationship between psychiatry and the colonial enterprise, arriving at differing conclusions, although all broadly in support of the central argument that psychiatry helped provide a rationale, under the guise of science, for existing practices of social control. However as many of the contributions show, this was by no means an uncontested or straightforward process. Distance from the center, Paris, London or Amsterdam, meant that the effectiveness of psychiatry was limited. In some cases it also created opportunities for innovation and critique although the viability of any alternative discourses and practice were, in the end, subject to the fate of the colonial governments.

The book contains nine separate, individually authored chapters, covering colonial experiences in East Africa, South Africa, Indonesia, Fiji, India and the Caribbean. Although there is no overall theory advanced, the chapters each contribute to a counter-argument to any simplistic view of colonial dominance. Colonial policies in various institutions were played out differently, influenced by local conditions. In addition, indigenous authorities, with or without the support of colonial theorists and officials, appropriated the instruments of colonization, in this case psychiatric science and practice, to challenge racism and oppression. If colonization is never complete, the opportunities for resistance are many, and the authors of Psychiatry and Empire provide some superb examples of oppressed group agency.

Perhaps one of the more spectacular cases is that of Algeria, in which Atoine Porot developed forward-looking community psychiatric services which were too advanced to be repatriated to Paris. Ultimately sidelined by decolonization, the Algiers School was far ahead of the carcereal models practiced in Europe. This development, however, was not a matter of colonial benevolence. Along with it went development of theories of 'the Islamic mind' which merit close attention in relation to current discussion of the West's relationship to Islam. Porot was able to theorize Algerian resistance in a way that made sense to French colonial authorities, and so remained an agent of colonization. In an interesting footnote Ropert Keller notes that the original observations of compound 4560 RP (later chlorpromazine) were made in Tunisia. The implications for the advancement of Parisian psychiatry were far reaching.

Unusually in a collection of this nature there is a chapter on mental health nursing. Historical studies tend to be influenced by available documentation, and by views of what voices merit attention in writing history. On both counts nursing is often excluded in accounts of early psychiatry, as there is a paucity of the sorts records that can help in writing that history, and because doctors, not least because they left behind a large volume of written records, are assumed to speak about the practice of psychiatry. Shula Marks' study of mental nursing at Valkenberg makes for harrowing reading. This is not simply a theoretical discussion; it is also a first hand account of the micropractices of abuse. The racism of early South Africa adds an extra dimension to the systematic cruelty of Valkenberg. In concluding, Marks comments on the fusion of disciplinary and sovereign power in the lives of nurses and asylum inmates, illustrating that their separation in many analyses is somewhat misleading.

Another interesting contribution is that of Jacqueline Leckie who writes about St Giles asylum in Fiji. Leckie argues that imported notions of madness became localized in Fiji, with existing views of normal behavior serving as benchmarks. In this chapter Leckie shows that it was not necessary to have the overt accoutrements of colonial institutions in order for psychiatry to become established, although that most powerful of symbols the asylum was constructed in 1886. The language of psychiatry came to infuse everyday medical and popular discourse, providing an efficient means of disseminating psychiatric control. Leckie gives numerous examples of the gendered construction of madness in Fiji. It is not clear, however, how madness is to be constructed if not according to accepted social norms. A woman, for example, whose conversation departs from her own community's accepted social norms and becomes fixated on sexual themes is likely manifesting some form of distress. Given that many women were referred to asylums by family members, psychiatry did not act alone in defining their behavior as 'abnormal' although it may well have lent considerable authority to family perceptions of madness. The use of family, cultural and social norms to define madness continues to be problematic today. If we must give due weight, for example, to cultural norms, that surely means accepting at times that cultural norms have been breached. The same can be said for gender. As Ian Hacking has pointed out, it is one thing to say something is socially constructed, but quite another to say what, if anything, there is beyond the construction.

Perhaps the best example of appropriation of western ideas is seen in Shruti Kapila's analysis of psychoanalysis in India. This is a truly fascinating chapter in which Freudian ideas are shown to be taken on their own terms, with local practitioners building a distinctive and indigenous discipline of psychoanalysis. Kapila shows how some of Freud's ideas were presaged by earlier Indian thinkers, and how Freud's theory of the subjective found fertile ground. The development of psychoanalysis was contemporaneous with critique of colonial rule, and it was of some advantage to the Indian psychoanalytic body, under Bose, to be at some remove from mainstream psychiatry. Nehru also took a close interest in psychoanalysis, but the two men reached opposite conclusions as to the relationship of the discipline to religion. For Bose, psychoanalysis gave religion the possibility of rational explanation; for Nehru psychoanalysis served the purpose of separating religion from politics. What they had in common was active engagement with psychoanalysis, illustrating one of the themes of Psychiatry and Empire; the role of agency in responding to the intellectual and political challenge of western ideas.

Psychiatry and Empire offers a diverse range of readings of interest to both history and to theory of transcultural psychiatry. They illustrate the larger debates about the historical and contemporary relationship between the West and its former colonies must be situated in local contexts if they are to be properly understood. Not only are there local factors that are unique to each setting, but in all the cases presented here, there is the question of how agency is enacted in specific times and places. Psychiatry and Empire is a valuable contribution to the history of psychiatry and to understanding current issues of cultural difference in mental health care.

© 2009 Tony O'Brien

Tony O'Brien, RN, MPhil, Senior Lecturer, Mental Health Nursing, University of Auckland,


Welcome to Metapsychology.

Note that Metapsychology will be moving to a new server in January 2020. We will not put up new reviews during the transition. We thank you for your support and look forward to coming back with a revised format.

We feature over 8300 in-depth reviews of a wide range of books and DVDs written by our reviewers from many backgrounds and perspectives. We update our front page weekly and add more than twenty new reviews each month. Our editor is Christian Perring, PhD. To contact him, use one of the forms available here.

Metapsychology Online reviewers normally receive gratis review copies of the items they review.
Metapsychology Online receives a commission from for purchases through this site, which helps us send review copies to reviewers. Please support us by making your purchases through our Amazon links. We thank you for your support!

Join our Google Group!

Interested in becoming a book reviewer for Metapsychology? To apply, write to our editor.

Metapsychology Online Reviews

Promote your Page too

Metapsychology Online Reviews
ISSN 1931-5716