In Psychiatric Contours, Nancy Rose Hunt and Hubertus Büschel present twelve contributions on the (post)colonial history of madness in Africa, divided into four parts: (auto)biographical writings on psychiatric illness, the history of specific diagnoses, colonial psychiatry’s interest in the supernatural and neglected sources. All contributors have established themselves as experts in the history of medicine or psychiatry, which is particularly impressive in the case of Raphaël Gallien, who was, at the time of the publication of this book, still a PhD student at Université Paris Cité.
Most of the chapters are nuanced case studies and micro-historical snapshots, focusing on a clearly defined set of cases or sources and carefully contextualized, with the few more ‘zoomed-out’ (p. 160) exceptions – such as the medical historian Jonathan Sadowsky’s excellent chapter on the widespread framing of depression as a ‘Western culture-bound syndrome’ (p. 157) – allowing for a broader understanding of some of the questions the book as a whole raises. Some chapters are composed in an almost conversational style, which makes for a captivating read. All contributors try to highlight blanks in research and literature, and to point out alternatives to rigid binaries in our interpretations.
In her introduction, Hunt, a historian and anthropologist of medicine, presents the book’s two axes. On the one hand, there are three key concepts, which informed the composition of the volume’s chapters (madness, psychopolitics and the vernacular) and on the other hand there is the need for new and experimental sources, interpretations and perspectives in psychiatric history. This includes the non-chronological mixing of chapters on colonial and postcolonial psychiatry – a justified critique in itself of the rigid break that decolonization often represents in research.
The first part of the book consists of three chapters, each focusing on the case of one specific man, ranging from the late colonial period (1940s Tanganyika) to early postcolonial settings (1960s–1970s Ghana and 1960s Nigeria). In Chapter 1, the medical historian Nana Osei Quarshie presents the psychiatric-patient file and petition of a man, Akla-Osu, interned for ‘schizophrenia’, which he categorizes as one example of a vast ‘archive of false prophets’ (p. 44). The provenance researcher Richard Hölzl presents, in Chapter 2, the case of an African priest, Father John, whose criticism of the Catholic Church was disregarded because of a potential diagnosis of hereditary syphilis, which allowed his superiors to dismiss him entirely as ‘“our problem priest” and “in fact a psychological case”’ (p. 83). In Chapter 3, the historian of psychiatry Büschel introduces the fascinating case of Benedict Nta Tanka, whose autobiographical account of his diagnosis of ‘schizophrenia’ was published by Alexander Boroffka in 1980 (p. 98).
The second part of the book includes a chapter by Gallien on 1920s colonial Madagascar, which follows the psychiatric diagnosis of four people who had initially been pro-French, but had ‘fallen into madness’ when they had failed to ‘meet colonial expectations’ (p. 138). In Chapter 5, Sadowsky presents the diagnosis of depression as one that was withheld from African patients, which he interprets as a ‘colonial gesture’ as much as the overapplication of certain other diagnoses (p. 172). This part concludes with a contribution by the medical historian Mathew M. Heaton, who looks at a colonial student survey about so-called ‘brain fag syndrome’, commissioned by the Canadian psychiatrist Raymond Prince in Nigeria in 1959.
The third part of Psychiatric Contours contains a study by the historian of psychiatry Sloan Mahone (Chapter 7), highlighting the focus of colonial officials – including psychiatrists – on spirit possession through an analysis of official reports on a province in Kenya in the 1950s. In Chapter 8, the medical historian Richard C. Keller presents the unique perspective of the psychiatric dissertation of Suzanne Taïeb – as ‘one of the very few women practitioners and very few Arabic speakers’ (p. 245) – on Muslim psychiatric patients in colonial Algeria.
The fourth part starts with a chapter by the social historian Romain Tiquet, who introduces a series of kin letters (letters by family members or neighbours), addressed in the 1960s to the governor of a region of Senegal, ‘asking to commit’ – and not release! – ‘a relative to a psychiatric unit’ (p. 257). In addition to the introduction, Hunt’s contribution to Psychiatric Contours includes an experimental tenth chapter, combining the dreams of a woman in the late colonial Gold Coast with descriptions of madness on a slave ship during the transatlantic slave trade. The volume is rounded off with a ‘coda’ by Büschel, who introduces a neglected category of sources, works of art produced by psychiatric patients, through an analysis of 1950s paintings from the Lantoro Mental Asylum in Nigeria.
The chapters presented in Psychiatric Contours are all short and well rounded. Some points, however, might have better been addressed in the framework of this edited volume: whereas most authors added, either in the chapters themselves or in footnotes accompanying the texts, that they anonymized their sources, this question remains open in others. Similarly, the decision to include images – in the midst of the ongoing discussion about the violence of colonial photography – remains unaddressed. A further minor observation: chapters on former Spanish, Italian or Portuguese African colonies would have been a welcome inclusion.
The most significant issue of this brilliant book is, from my perspective, the intentional vagueness of the term ‘vernacular’. Hunt portrays this ambiguity of the term in her introduction as at once deliberate and an advantage for historians and anthropologists of madness in Africa (p. 20), yet this argument is not entirely convincing. While the book overall feels like a solid introduction to the complex history of (post)colonial psychiatry in Africa, aimed at a more general public, this vagueness – mirrored in how the chapters treat the term – makes Psychiatric Contours a little inaccessible. The book’s strongest aspects are undoubtedly the chapters themselves, which are valuable contributions to the history of madness in Africa. As each chapter highlights new approaches, sources and perspectives, they offer an excellent snapshot of what remains to be done – and, perhaps, what should be undone – by historians of psychiatry today.
