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technical paper
"The Sorcerer Hides in Genes": Responsibility and Kinship in the Psychiatric Clinic
keywords:
africa
immigration and diasporas
kinship and families
In a 1991 article, the prominent Cameroonian psychiatrist Mathias Makang Ma Mbog argued that "the African family is increasingly becoming a site of doubt and worry. Modern medical culture increasingly teaches society that if, in a couple, the brother is mad or the mother is psychotic, the children will inevitably inherit some parental defects... the family culture is thus becoming pathologized by medical discourse. Previously, there was reassurance in knowing that madness came from the sorcerer. Now, the sorcerer hides in genes" (26). Drawing on 24 months of dissertation fieldwork, this paper examines how psychiatric treatment and psychoeducation intervene in relationships between hospitalized patients and familial caregivers (gardes malades ) at Cameroon's flagship public psychiatric clinic. Playing with Nikolas Rose' (1990, 2017) notion of "responsibilization," I contend that the explanatory framework of neuropsychiatry both "de-responsibilizes" patients and families from communal accusations of sorcery -- of having caused their own distress through immoral behavior -- and "re-responsibilizes" patients through the prescription of what the hospital calls "mentally hygienic behavior," and families, through the language of pathologized inheritance, including notions of "genetic defect." Which forms of care and obligation are foreclosed by this moral work of the clinic, which are made possible, and to whose benefit? How do clinical rearrangements of responsibility shape the contours of life after hospitalization -- of the very idea of what it means to be well, and who can be well?