This Societal Dimensions of Engineering, Science, and Technology Dissertation Improvement Grant will provide research funding for a Ph.D. student to help complete her dissertation on the intersection of psychiatry and religious cultural systems, in particular Spiritist psychiatry in contemporary Brazil. The dissertation analyses Spiritist psychiatric practice and spiritual practice by providing case studies of two Spiritist Psychiatric hospitals, using phenomenological and qualitative analysis of ethnographic observation and expert interviews. These case studies are contextualized within a bibliographical research and a general survey of psychiatry in Brazil. Spiritist psychiatry is a professional psychiatric system that has developed distinctly different from Euro-American psychiatry by bolstering standard neuro-scientific practice with spiritual treatment modalities. This work focuses on moral and cultural interpretations of mental illness by health care professionals, and how their beliefs interact with psychiatric knowledge and practice. It raises the issue of how mental illness is understood as a diagnosis or disease and as a set of local and contingent practices rooted in culture and political economy. It addresses the neglected vector of cultural meanings in the construction of psychiatric intervention. Spiritism, a religious movement with Euro-American origins, could be called a "modern spirit possession religion," since its practices involve systematic and regular contact with the dead. Spiritists administer about a third of private psychiatric hospitals in Brazil and claim to not only treat mental illness more successfully and effectively, but to also explain the causes of mental illness. In their view most mental illness is originally caused by "obsessing spirits," and they conceptualize mental illness as ultimately originating from the moral failure of the mentally ill person, attributing individual responsibility to the patient. This spiritual etiology is in marked contrast to contemporary neuroscientific psychiatry, which locates mental illness in the body, i.e. as a physiological malfunction, and psychoanalysis, which locates mental illness in the mind, i.e. an emotional malformation. The Spiritist psychiatric hospital then is a site of contradiction, in which multiple competing and opposed epistemologies intersect, clash and ultimately coexist. This dissertation analyzes the following: 1) how Spiritist psychiatrists conceptualize, treat, and the meaning they attribute to mental illness, and 2) how they negotiate their professional psychiatric knowledge with their religious moral beliefs about madness. This dissertation makes several important theoretical contributions and intersects with several theoretical fields, such as the anthropology of religion and religious healing, transcultural psychiatry, and ethical dimensions of science and technology. This project further provides one of the rare discussions of the religiosity of psychiatrists and its influence on patient treatment. It provides a complementary and missing piece to the emergent investigation of modernity and subjectivity at the intersection of psychiatric institutions, religious cultural systems and modernity. This dissertation addresses both psychiatric and anthropological concerns. It illuminates the history and practice of psychiatry and its relationship to religion and cultural identity in contemporary Brazil. The theoretical and practical investigation of the cultural. construction of psychiatric intervention will further the understanding of the cultural adaptations of professional psychiatries in non-western contexts and is both timely and important in addressing neglected vectors in mental health with possible application in public policy, specifically, the negotiation of morality; professional values and ethics; and prejudice, stigma and stereotyping.
