It would be fair to say that before coming to Chad, in the months leading up to this mission, I was expecting something alien. Conditions and life-ways so extreme and dimensionally different from mine that I would struggle to connect with them. In anthropological parlance, I exoticised the other. This is almost never a good thing. It is also somewhat inevitable, at least when exploring new terrain, however much you try and keep it in check. In order to minimize the anxiety of the unknown and unexpected, we start entertaining possibilities. Like mythologies and daydreams, they have no direct correspondence with reality, but these animated exhalations are good to think with. Like a mental jungle-gym. The problem is not in doing this. Quite to the contrary, exploring hidden assumptions and their entailments are the scaffolding of psychotherapy. Or most any insight-oriented activity, really. Rather, the problem would be in affording these guesses, assumptions or projections a stability that does not reflect their arbitrariness and self-soothing origins. In the first post that I wrote, I asked some semi-rhetorical questions:
How can a psychiatrist WWHUUMMP parachute into central Africa and expect to do anything useful?
*Tense sigh* These people have suffered such incomprehensibly intense, sustained, and unpredictable trauma, and the situation remains horrendous!! What do you say to a person who has lost his or her family, community, and livelihood?! What do you say to the woman who has been repeatedly raped when going out at night for firewood, and will continue to do so because her children will die without cooked food?! What do you say to say to a child who has been orphaned, neglected, and abused?! What can a psychiatrist do?!?
Both questions are of the same form: what can a psychiatrist do when he or she has no clue how to connect with unfamiliar circumstances? The uncertainty was palpable—and sensationalistic. [Read more…]