The Dakhla Oasis: Stories from the ‘field’: Bahariyya, Farafra, and back to Giza

By the time I reached Bahariyya Oasis, I realised that setting off from Cairo at 8 o’clock in the morning was not a wise move. Three and a half hours and three hundred and fifty kilometres later I was standing in the scorching sun with a further hundred and seventy kilometres to Farafra Oasis. I decided this was a good time to have a break. Just beyond Bahariyya lies a small village, El-‘Heiz, comprised of a few wells, palm tree gardens, and a number of houses just visible from where I stood in the middle of the road. On the other side of the road was a rectangular purpose built ‘café’ baking in the noon sun, a structure that served as the main source of income and residence for a small family. As I stepped inside and into the shade I was immediately struck by the number of people in the place. A large group of tourists on their way back to Bahariyya from the desert were scrawled along the floor mats on one side of the café enjoying the lone electric fan. On the other side of the café, sitting around a couple of tables, were the group’s four guides and two of the café owner’s children; a boy of about six and a girl of maybe twelve or thirteen. Right in the middle, and seated behind a table covered with bits and pieces – gum, small clay sculptures, scarves, hand-made leather bags, earrings, crisps and biscuits – was a middle-aged woman, the café owner’s wife.

I ordered a tea and sat around one of the tables, within viewing distance of a laptop one of the guides had on. He was playing a video clip of Dina, a famous Egyptian belly dancer, shaking semi-naked to the beats of the ‘Darabokka’. Among the audience seated around the laptop were the two young children. I noticed that the girl was wearing a ‘hijab’ (head scarf) while her mother was not. The guide engaged me in conversation, initially mistaking me for a tourist, not because of my looks which are evidently Egyptian, but because I didn’t throw the customary greeting – Assalamu ‘alikum – as I entered the café. The tea arrived at the moment the entertainment was changed, this time a video clip for a female singer – Haifa’ Wahbe – who is famously known as a surgically enhanced Lebanese bombshell. In this clip she was swaying provocatively to some non-descript song. A few minutes later and at the insistence of the two bored children, the guide played what they evidently found a more exciting video: two American women in bikinis wrestling in a rink surrounded by an audience in the hundreds. The children where laughing and jeering and thoroughly enjoying the show.

As the conversation slowly picked on with one and then all three of the guides, they came to know that I am a doctor, and enthusiastically informed me of the name of the doctor who runs Farafra general hospital. One of the guides thought I should hook up with him when I arrive to Farafra as, in his own words, “our minds would meet”. I asked them about the current state of development in the Oases, they were able to comment on Bahariyya and Farafra. Farafra, one of them said, is growing steadily. More and more people are moving there from the big cities along the Nile – El-Minia, Asyut, Cairo – capitalising on the cheap, fertile land and finding their livelihood in growing crops. The oasites – they all agreed – mainly work the land, with a few owning a small shop here and there. A large number of able young men have taken to the steadily increasing – and profitable – tourist trade, escorting groups in to the White desert and beyond to the ‘Gilf El-Kebir’, a sea of dunes on the Eastern edge of the Sahara desert. As to the ethnic composition of the population, the traditional distinction between Bedouins and Egyptians seems to be slowly collapsing. Intermarriage and decline in the nomadic life style meant, as one of the guides said, that no real Bedouins exist anymore in Egypt, with the possible exception of Siwa Oasis (fifty kilometres from the Libyan border) and the Sinai Peninsula.

The conversation was cut short as the guides together with the tourist group had to leave. I remained with the café owners and their three children (a two year old had appeared by now). A third man – a friend of the owner – had also showed up midway in the wrestling video. Left in silence for a moment I found myself contemplating what seemed to me glaring contradictions – young children, semi-naked women, a twelve year old veiled girl, her unveiled mother, Bedouins who are no longer Bedouins, a greeting that defines identity, the same identities (Bedouin and Egyptian) that are in flux – yet judging from the relaxed conduct of everyone there, I couldn’t shake the thought that the contradiction might only be in my head.

I was cut short by the café owner – the woman – asking me, as a doctor, if I can advise her on her two year-old’s peculiar skin discolouration. After informing her that dermatology is not my speciality she told me how a number of doctors have failed to cure her son. The other man in the room interrupted, saying that he knows a local Sheikh who cures skin problems by rubbing a mixture of pigeon droppings and other secret ingredients on the discoloured areas, a cure that works, he said. The child’s father quickly responded: “that’s all superstition”. His wife nodded her head in agreement, looked in my direction and added in a tone of slight embarrassment: “but customs and traditions are beautiful”. The man who suggested going to the Sheikh for a cure then added that, in any case, the child must have received a “very bad eye”. The parents agreed, and the mother recounted an incident where a woman, a distant acquaintance, commented on the beauty of the boy. A few days later his skin flared with these dark lesions.

I leave the café, head to the car, and drive off to Farafra. On arrival and having settled down I sought some entry point to my research. Since my main goal is to study psychopathology in the area, I thought a visit to the local hospital might provide some initial links. Farafra general hospital is a two storey building with a small A&E department that handles minor cases and a number of clinics in the main branches of medicine, in addition to a few wards. There was no psychiatry. The hospital deputy director had no information to give me on psychiatric cases in the region. I decided to head off to the health authority, and was granted an audience with the only General Practitioner in Farafra; he knew more. Over the past fours years he had only seen two cases of what he thought was schizophrenia. He was quick to explain that he has no special knowledge in psychiatry; the presentation of one of those two men, as he described it, was as follows: “persecutory and grandiose beliefs, disturbed and dangerous behaviour, talking to self”. That was all he could remember. He recalled sending this man to the main mental health hospital in Cairo. “There are no psychiatrists in El-Wadi El-Gedid” he said, “the nearest being 550 km in Cairo, or in Asyut” [1]. I asked him if he thinks cases of ‘madness’ are rare in Farafra, or – alternatively – if the people handle these cases in a totally different framework, thus not appearing before medical professionals. He endorsed the latter view, and suggested that I link in with local traditional healers to find an answer for my question.

I returned to the small hotel where I was staying and struck a conversation with one of the young men working there. He was from Dakhla oasis and returns there in the hot summer months as tourism drops then. “Psychiatrists,” he said, “are the last resort, if you need a psychiatrist then you have truly hit rock bottom, and here this is a disgrace – ‘eib[2], and is to be avoided if possible”. People in the oases, he continued, go to Sheikh’s who specialise in healing, some of whom are proficient and some are charlatans – daggaleen. According to him those healers are not short of work; in the oases jinn possession is quite common due to the prevalent marshes and darkness, places and situations where the jinn tend to reside. He advised me to speak to an acquaintance of his, Sheikh Ali, a Cairo based healer who has treated many a case of possession in the Oases and abroad.

As night approached I retired to a seating area at the hotel entrance, where a cool breeze was finally blowing, and started reading a book. I was interrupted by two hotel staff, ‘Adel and Hussein, who were attracted by the same rare breeze and we struck a conversation. What followed was a spontaneous chat that – without any prompting on my behalf – steered in the direction of the supernatural and was dominated by talk about jinn. ‘Adel was explaining how certain Sheikhs have the power to enslave jinn and use them to “pull” treasures buried deep under the ground, treasures such as Pharaonic statues, gold, and red mercury, an extremely rare and valuable substance that was used for mummification. A proficient Sheikh is not only able to “pull” treasure from a certain site, but can also do so from a distance. Furthermore Sheikh’s differ in their “pulling” power; some can “pull” at a depth of fifteen kilometres, others at five, and others can only fix a treasure’s place in the ground. As for the jinn they inhabit the different layers of the earth and have the power to possess people. Once possessed, a person would behave in bizarre ways, and would return to normality only when the jinn leave their body. At that point I interjected and asked them what, if any, is the difference between possession and gonoon. “The jinn can make a person mad – magnoon – but there is also madness – gonoon – that is not due to possession” ‘Adel answered, “this is when a person’s mind becomes loose – yefawwet. If after excorcism is attempted the person remains weird – gharieb – then something must be wrong with their mind and in this case they need a doctor, but that is the last resort”.

At that ‘Adel recounted a story of a man who used to lock himself in a public bathroom and talk to himself. ‘Adel found him there once, and asked him to get out. A voice responded: “leave him alone”. This, ‘Adel explained, was no doubt a jinn talking through the man. ‘Adel threatened the jinn with a beating if he doesn’t leave; a few minutes later the man opened the bathroom door, was crying and left the building. Hussein gave support to this anecdote, confirming that the possessing jinn could leave the body after the possessed person is beaten. He said that a beating is directed, essentially, at the jinn and the person feels nothing. By the end of the conversation I felt that I must visit Sheikh Ali. I left Farafra the following morning.

Back in Cairo I called Sheikh Ali, I explained the purpose of my research and he was very welcoming and keen to receive me. His office is located in a narrow alley off El-‘eshrein road, an inconceivably long road in one of the busiest districts of Giza. After walking for about twenty minutes, all while dodging cars, people, mini-buses, bicycles, motorcycles, goats, cats, and Chinese motorised tricycles, I found him waiting for me at the agreed upon meeting point. Sheikh Ali is a man in his fifties; originally from Aswan he settled in Cairo, opened an Estate Agent office and practices what he calls ‘Spiritual Healing’ on the side. He treats people in Cairo and regularly travels to the Western desert where he finds tens of people bringing their ill children, friends, and relatives. His competence also brings him foreign patients from Gulf States, who occasionally invite him abroad to cure a difficult case.

Sheikh Ali treats people possessed by jinn. But he also identifies other categories of illness which he calls ta’ab nafsi (‘self-distress’) and gonoon (madness) in addition to bodily illness which is in the rightful domain of medicine. He considers possession and ‘self-distress’ to fall within his domain of competence, while gonoon is more of a medical problem. (The jinn can make you mad – magnoon, but once they are removed you should return to sanity). The distinction between these three categories relies on discerning a number of symptoms, the course of the condition, the effectiveness of certain treatments, comprehensibility of the patient, and more generally – as he explained – on the healer’s clinical sense, experience, and intuition. When first hearing about a case he tries to answer three questions: (1) is it possession, ‘self-distress’, or madness? (2) Would long-distance treatment be possible or does he need to see the person face to face. (3) What are the causes; specifically is magic involved or not? In a way possession is the presumed category until proven otherwise.

In my interview with him he listed the most common symptoms a possessed person could present with:

  • Frequent dreams and nightmares, especially of being followed and persecuted.
  • People (voices) talking to the person.
  • The feeling of being controlled and directed by someone or something.
  • Involuntary movements of the limbs.
  • A feeling of something moving up and down the body.
  • Fears of being killed.
  • Pain travelling along the body.
  • Feelings of suffocation.
  • Back, shoulder, and stomach pains.
  • Irritability and sudden loss of temper.
  • Poor memory.
  • Sometimes complete mutism for long periods of time.
  • Sleep: could be much more or less than the average for the person.
  • Appetite: increased or decreased.
  • Sometimes sexual arousal.
  • The course is usually cyclical, with the person being unwell when possessed and regaining complete lucidity and mental well-being in between such episodes. The duration of the episodes, however, could be anything from a few days to a few years.

Sheikh Ali contrasted such a course with that of ‘self-distress’ which is usually more long lasting, stable, and does not display such cyclical changes. Occasionally some people fake the symptoms of possession, for reasons to do with attention seeking, or to force their family to get them what they want. Through subtle differences in presentation (such as an incoherent constellation of symptoms), Sheikh Ali is usually able to distinguish the malingering from the real.

As to the causes of possession, these could be divided in to two categories:

  1. Where no magic is involved, but – for a variety of reasons – the person is weak and vulnerable to the jinn:
    • Falling in a place where the jinn are known to reside. These include bathrooms and door steps at the entrances of houses.
    • Visiting a house or room that had been locked up for a long time.
    • Dark areas.
    • Looking at mirrors for a long time.
    • Having many photos in one room.
    • Coming too close to fire.Social isolation stemming from sadness after any major loss; the isolation renders people vulnerable.
    • Women at the time of menstruation, as they are ‘impure’ – mesh tahreen, do not have the protection of angels, and hence are vulnerable.
  1. Magic has been perpetrated against the person:

– Magic could be done on a person with the purpose of directing jinn at them. In this instance the jinn are usually by definition evil – jinn soflee – and particularly hard to get rid off.

Treatment proceeds by removing the possessing jinn and, if appropriate, undoing the magic. Successful removal of the jinn depends on many factors. Sheikh Ali described a variety of jinn: you have the powerful and the weak, the Muslim and the Christian, male and female, good and evil, and so on. Male patients are usually possessed by female jinn, and the converse also holds. The exorcism process is essentially a struggle between the power of the jinn and the powers of the healer, where the healer is the tool through which the power of the Qur’an and ultimately God is unleashed. Sheikh Ali mainly treats his patients by reading specific verses from the Qur’an while talking to the jinn and urging them to leave. He describes how he usually manages to talk directly to the jinn through the patient, who in this case would have an altered voice. This helps in diagnosis and treatment for two reasons: first it is a direct confirmation of possession and second the jinni might indicate its power and religion, which determines which verses would be effectual.

The jinn respond in different ways. Occasionally the jinn leave as the patient is entering the treatment room. Sheikh Ali explained that the jinn know what’s going on and some of them – the weaker ones – would dread the Qur’anic sessions and leave of their own accord. The Qur’anic verses are usually sufficient to dispel all but the most powerful jinn. With these, treatment might extend for weeks on end. Sheikh Ali recalls how the jinn sometimes respond with arrogance: “no matter what you do we won’t come out”, in which case he perseveres. In addition to reading the Qur’an he occasionally uses a second method of exorcism: a piece of cloth is set on fire then extinguished, and while still smouldering is quickly passed across the patient’s nose. The smoke, Sheikh Ali explains, is the jinn’s biggest fear; as creatures of fire, smoke signals their death. He mentioned other treatments which he generally condones but other people use: these include beating the patient at certain bodily points to force the jinn out, and burning some of the patient’s belongings.

Sheikh Ali told me of a case he had recently worked with. He was a young man in his early thirties living in Dakhla Oasis and who had been displaying very strange behaviour for the best part of two years: he would roam around at night setting fire to palm trees, apprehend people in the street (some of whom were strangers) and asking them if he could marry their daughters, standing in front of police cars and shouting, he was barely sleeping or eating. His family sent him to a number of hospitals in Cairo where he was heavily sedated only to return back to the Oasis and resume his bizarre behaviour. While in Aswan, Sheikh Ali heard about him and was able to discern that magic was perpetrated on this man, in this case the unaware man drunk a magical potion. This made him vulnerable to the jinn and he was in fact possessed. Sheikh Ali provided long-distance treatment from Aswan by invoking the possessing jinn’s consort – qareen – and reading Qur’anic verses. Over the next six days and after repeated episodes of vomiting the man expulsed the poison. With the magic undone the jinn left his body and, according to Sheikh Ali, the man returned to health, resumed work and has been well since. He explained that no amount of medication would cure or help a possessed person so long as the jinn are still there. Healing, Sheikh Ali told me, is a gift – malaka; not everyone has it. A healer must remain calm in the direst of situations and absorb the patient’s distress. A healer must be close to God and must have full faith in the elements of the healing framework. Unfortunately, he continued, unemployment and poverty have led many people to claim healing powers, when in fact all they do is read verses from books on healing without any understanding of the healing process. These he called charlatans – daggaleen.

Once the jinn are removed the patient would improve but elements of ‘self-distress’ – ta’ab nafsee – might remain. This usually takes the form of a bad mood, irritability, or sadness and is amenable to reassurance, social advice, reading the Qur’an and praying. The problem with psychiatry – Sheikh Ali explained – is that it treats every case as either ‘madness’ – gonoon – or self-distress’ ignoring the reality of possession, as such medical treatments are frequently ineffectual. The third category recognised by Sheikh Ali, madness – gonoon, is reserved for the most extreme and hopeless cases. The mad, he explained, are not possessed; their brains have ‘turned around’ – mokho laff, their minds are ‘loose’ – ‘aqlo sayeb. Sheikh Ali identifies madness through a number of signs: the most important is that you can’t reason with them, their speech is un-explicable – mesh metfassar ­– and they are not aware. By aware he doesn’t mean a grade of consciousness but awareness of the situation they are in. Alternatively a judgment of gonoon could ensue once all possible ‘spiritual treatment’ is provided over an extended period of time with no effect. In most cases, however, it is a combination of the aforementioned signs together with ineffectual treatment that leads to a judgment of gonoon. Once that occurs, Sheikh Ali continued, psychiatrists could be consulted.

At the end of our meeting Sheikh Ali informed me that now I have learnt the “theory” behind his work, the next step is to attend healing sessions with him to see how things are done in practice.


Public Mental Health Across Cultures: The Ethics of Primary Prevention of Depression, Focusing on the Dakhla Oasis of Egypt

(Introduction to a chapter I wrote with Rachel Bingham. It will be part of the volume ‘Mental Health as Public Health: Interdisciplinary Perspectives on the Ethics of Prevention’, edited by Kelso Cratsley and Jennifer Radden.)

 

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For over a decade there has been an active and ambitious movement concerned with reducing the “global burden” of mental disorders in low- and middle-income countries.[1] Global Mental Health, as its proponents call it, aims to close the “treatment gap”, which is defined as the percentage of individuals with serious mental disorders who do not receive any mental health care. According to one estimate, this amounts to 75%, rising in sub-Saharan Africa to 90% (Patel and Prince 2010, p. 1976). In response to this, the movement recommends the “scaling up” of services in these communities in order to develop effective care and treatment for those who are most in need. This recommendation, the movement states, is founded on two things: (1) a wealth of evidence that medications and psychosocial interventions can reduce the disability accrued in virtue of mental disorder, and (2) closing the treatment gap restores the human rights of individuals, as described and recommended in the Convention on the Rights of Persons with Disabilities (Patel et al. 2011; Patel and Saxena 2014).

In addition to its concern with treatment, the movement has identified prevention among the “grand challenges” for mental and neurological disorders. It states, among its key goals, the need to identify the “root causes, risk and protective factors” for mental disorders such as “modifiable social and biological risk factors across the life course”. Using this knowledge, the goal is to “advance prevention and implementation of early interventions” by supporting “community environments that promote physical and mental well-being throughout life” and developing “an evidence-based set of primary prevention interventions” (Collins et al. 2011, p. 29). Similar objectives have been raised several years before by the World Health Organisation, who identified evidence-based prevention of mental disorders as a “public health priority” (WHO 2004, p. 15).

Soon after its inception, the movement of Global Mental Health met sustained and substantial critique.[2] Essentially, critics argue that psychiatry has significant problems in the very contexts where it originated and is not a success story that can be enthusiastically transported to the rest of the world.[3] The conceptual, scientific, and anthropological limitations of psychiatry are well known and critics appeal to them in making their case. Conceptually, psychiatry is unable to define ‘mental disorder’, with ongoing debates on the role of values versus facts in distinguishing disorder from its absence.[4] Scientifically, the lack of discrete biological causes, or biomarkers, for major psychiatric conditions has resulted in the reliance on phenomenological and symptomatic classifications. This has led to difficulties in defining with precision the boundaries between disorders, and accusations that psychiatric categories lack validity.[5] Anthropologically, while the categories themselves are associated with tangible and often severe distress and disability, they remain culturally constructed in that they reflect a ‘Western’ cultural psychology (including conceptions of the person and overall worldview).[6] Given this, critics see Global Mental Health as a top-down imposition of ‘Western’ norms of health and ideas of illness on the ‘Global South’, suppressing long-standing cultural ideas and healing practices that reflect entirely different worldviews. It obscures conditions of extreme poverty that exist throughout many non-Western countries, and which underpin the expressions of distress that Global Mental Health now wants to medicalise. On the whole, Global Mental Health, in the words of the critics, becomes a form of “medical imperialism” (Summerfield 2008, p. 992) that “reproduces (neo)colonial power relationships” (Mills and Davar 2016, p. 443).

We acknowledge the conceptual, scientific, and anthropological critiques of psychiatry and have written about them elsewhere.[7] At the same time we do not wish to speculate about and judge the intention of Global Mental Health, or whether it’s a ‘neo-colonial’ enterprise that serves the interests of pharmaceutical companies. Our concern is to proceed at face-value by examining a particular kind of interaction: on one hand, we have scientifically grounded public mental health prevention campaigns that seek to reduce the incidence of mental disorders in low- and middle-income countries; on the other hand, we have the cultural contexts in these countries where there already are entirely different frameworks for categorising, understanding, treating, and preventing various forms of distress and disability. What sort of ethical principles ought to regulate this interaction, where prevention of ‘mental disorders’ is at stake?

The meaning of prevention with which we are concerned in this chapter is primary, universal prevention, to be distinguished from mental health promotion, from secondary prevention, and from primary prevention that is of a selective or indicated nature. Primary prevention “aims to avert or avoid the incidence of new cases” and is therefore concerned with reducing risk factors for mental disorders (Radden 2018, p. 127, see also WHO 2004, p. 16). Secondary prevention, on the other hand, “occurs once diagnosable disease is present [and] might thus be seen as a form of treatment” (Radden 2018, p. 127). In contrast to prevention, mental health promotion “employs strategies for strengthening protective factors to enhance the social and emotional well-being and quality of life of the general population” (Peterson et al. 2014, p. 3). It is not directly concerned with risk factors for disorders but with positive mental health. With universal prevention the entire population is within view of the interventions, whereas with selective and indicated prevention, the target groups are, respectively, those “whose risk for developing the mental health disorder is significantly higher than average” and those who have “minimal but detectable signs or symptoms” (Evans et al. 2012, p .5). While there is overlap among these various efforts, we focus on primary, universal prevention. Our decision to do so stems from the fact that such interventions, in being wholly anticipatory and population wide put marked, and perhaps even unique, ethical pressure on the encounter between the cultural context (and existing ideas on risk and prevention of distress and disability) and the biomedical public mental health approach.

It is helpful for ethical analysis to begin with a sufficiently detailed understanding of the contexts and interactions that are the subject of analysis. With these details at hand, what matters in a particular interaction is brought to light and the ethical issues become easier to grasp. Accordingly, we begin in section 2 with an ethnographic account of the primary prevention of ‘depression’ in the Dakhla Oasis of Egypt from the perspective of the community. The Dakhla Oasis is a rural community where there is no psychiatric presence or modern biomedical concepts yet – like most communities around the world – there is no shortage of mental-health related distress and disability. It is a paradigmatic example of the kind of community where Global Mental Health would want to action its campaigns. In section 3 we move on to the perspective of a Public Health Team concerned with preventing depression in light of scientific and evidence-based risk factors and preventive strategies. Section 4 outlines the conflict between the perspective of the Team and that of the community. Given this conflict, sections 5 and 6 discuss the ethical issues that arise in the case of two levels of intervention: family and social relationships, and individual interventions.

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Notes:

[1] See Horton (2007), Prince et al. (2007), and Saxena et al. (2007).

[2] Most recently there was vocal opposition to a ‘Global Ministerial Mental Health Summit’ that was held on the 9th and 10th of October 2018 in London. The National Survivor and User Network (U.K.) sent an open letter to the organisers of the summit, objecting to the premise, approach, and intention of Global Mental Health.

[3] See Summerfield (2008, 2012, 2013), Mills and Davar (2016), Fernando (2011), and Whitley (2015).

[4] For debates on the definition of the concept of mental disorder consult Boorse (2011), Bolton (2008, 2013), Varga (2015), and Kingma (2013).

[5] For discussions of the (in)validity of psychiatric categories see Kinderman et al. (2013), Horwitz and Wakefield (2007), and Timimi (2014). Often, the problem is framed by asking whether mental disorders are natural kinds (see Jablensky 2016, Kendell and Jablensky 2003, Zachar 2015, and Simon 2011).

[6] See, for example, Fabrega (1989), Littlewood (1990), and Rashed (2013a).

[7] For example: Rashed and Bingham (2014), Rashed (2013b), and Bingham and Banner (2014).

More Things in Heaven and Earth

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For a few months in 2009 and 2010 I was a resident of Mut, a small town in the Dakhla Oasis in the Western desert of Egypt. My aim was to become acquainted with the social institution of spirit possession, and with sorcery and Qur’anic healing (while keeping an eye on how all of this intersects with ‘mental disorder’ and ‘madness’). I learnt many things, among which was the normalness with which spirit possession was apprehended in the community: people invoked spirits to explain a slight misfortune as much as a life- changing event; to make sense of what we would refer to as ‘schizophrenia’, and to make sense of a passing dysphoria. It was part of everyday life. The way in which spirit possession cut across these diverse areas of life got me thinking about the broader role it plays in preserving meaning when things go wrong. To help me think these issues through I brought in the concepts of ‘intentionality’ and ‘personhood’. The result is my essay More Things in Heaven and Earth: Spirit Possession, Mental Disorder, and Intentionality (2018, open access at the Journal of Medical Humanities).

The essay is a philosophical exploration of a range of concepts and how they relate to each other. It appeals sparingly, though decisively, to the ethnography that I had conducted at Dakhla. If you want to know more about the place and the community you can check these blog-posts:

The Dakhla Diaries (1) : Fast to Charing-X, Slow to Hell

The Dakhla Oasis: Stories from the ‘field’ (0)

The Dakhla Diaries (3): Wedding Invitation

Old Mut, Dakhla

The Dakhla Oasis: Stories from the ‘field’ (I)

And this is a piece I published in the newspaper Al-Ahram Weekly (2009) voicing my view on some of the practices that I had observed: To Untie or Knot

 

Spirit Possession, Personhood, & Intentionality: Perspectives for the Philosophy of Mental Health

Summary of an essay I completed recently.

Spirit possession is a common phenomenon around the world in which a non-corporeal agent is involved with a human host. This manifests in a range of maladies or in displacement of the host’s agency and identity. Prompted by engagement with the phenomenon in Africa, this paper draws some connections between spirit possession, and the concepts of personhood and intentionality. It employs these concepts to articulate spirit possession, while also developing the intentional stance as formulated by Daniel Dennett. It argues for an understanding of spirit possession as the spirit stance: an intentional strategy that aims at predicting and explaining behaviour by ascribing to an agent (the spirit) beliefs and desires, but is only deployed once the mental states and activity of the subject (the person) fail specific normative distinctions. Applied to behaviours which are generally taken to signal ‘madness’ or ‘mental illness’, the spirit stance preserves a peculiar form of intentionality where otherwise behaviour would be explained as consequence of a broken physical mechanism. Centuries before the modern disciplines of psychoanalysis and phenomenological-psychopathology endeavoured to restore meaning to ‘madness’, the social institution of spirit possession had been preserving the intentionality of socially deviant behaviour.