Social Identities, v. 6. New York: Berghahn Books, 2011. xiii, 173 pp. (Map.) US$70.00, cloth. ISBN 978-0-85745-094-4.
As it often happens, the fieldwork that informs Out of Place was born out of intellectual irritation and happenchance. As an undergraduate, Michael Goddard was disturbed by the tendency at the time to present cultures as if they included no people as such but rather were assemblages of structures. A chance summer job working at a community mental health centre led to an MA thesis drawing upon the life histories of ex-psychiatric patients and subsequently to PhD research in 1985-86 on “mental illness” in the upper Kaugel Valley in the Western Highlands Province of Papua New Guinea. Goddard drew on his dissertation for a number of articles, but restricted public access to the manuscript “due to the nature of some of its content” (x). Goddard doesn’t specify what revisions he has made to the original manuscript, but one senses that they are fairly light. For instance, he makes no reference to the extensive and lively literature on indigenous constructions of personhood, despite its obvious relevance, one supposes because this was not yet a burning topic in the mid-1980s. The book is more narrowly focused.
The running theme that links the chapters and inspires the title is that the Kakoli people at the time of Goddard’s fieldwork lacked a concept of mental illness and thus any attempt to describe their “ethnopsychiatry” would be empirically impossible and conceptually false. The Kakoli did have a word (kekelepa) they applied to what would conventionally be understood as madness. Yet they used the same term for a wide array of behaviours ranging from confusion and random violence to acting out and drunkenness. In an earlier publication, Goddard had translated kekelepa as “crazy,” “silly” or “irrational.” He suggests here that a more accurate gloss would be actions “estranged from the ‘normal’ behaviour of the group”—that is to say, actions that are “socially ‘out of place’” (70-71). The Kakoli provided a wide variety of explanations for kekelepa behaviour when it occurred, none of which, unlike explanations for illnesses, suggested a “logics of causality” (77). They accepted, apparently without much concern, that fits of kekelepa might come and go for no apparent reason. In sum, madness was behaviour that was out of place socially and for which there was no apparent cause.
Out of Place follows two tracks, only loosely joined by the often-repeated theme that a psychiatry based on an assumption of mental illness makes little sense in a cultural context lacking a mind/body ontology. The first is a critical history of the development and practice of psychiatry in Papua New Guinea, beginning with the passage of an “insanity ordinance” in 1912 up to the present, concentrating on the establishment of mental health services in the late colonial period. These opening chapters make distressing reading, not just for the typically abysmal treatment giving the unfortunates who ended up in psychiatric facilities but also for the yawning gap between the ideal of cultural sensitivity tirelessly promoted by the head of the mental health services, Dr. B.G. Burton-Bradley, and the reality. The reality was and almost certainly remains that clinical psychiatric treatments were employed primarily to control disruptive individuals.
The second track of Out of Place is an ethnographic account of madness as encountered by the author in the remote high Kaugel Valley in the mid- 1980s. The key word here is “encountered,” as Goddard is very present in the case histories he presents. He begins in chapter 2 with six individuals who had spent periods in the secure ward at Goroka Hospital for whom there were records he was allowed to access. These brief accounts establish that the Kakoli as much as the Administration treated psychiatric interventions as a form of social control. The following chapter investigates the rather diffuse understandings of madness in the context of indigenous notions about causes and responses to sickness, emphasizing the anomalous status of kekelepa as a condition defined more in terms of an implicit violation of community morality than overt behaviours and thus not something that can be cured.
The remaining three substantive chapters present detailed field-based studies of four individuals the Kakoli considered to be mad. The cases serve to illustrate the highly contextualized, speculative and shifting nature of Kakoli explanations of and responses to kekelepa, ranging from assertions of spirit possession to a vague notion of seasonal madness. Just as interestingly, the case histories illustrate the contextualized and shifting understandings of the author in his own encounters with these individuals and their neighbours. Goddard is very present in these accounts, describing his attempts to track down the individuals and document local explanations for their behaviour as well as providing vivid descriptions of kekelepa incidents he witnessed. He very honestly describes his own shifting understandings of what often appeared to him as psychotic episodes in a context in which such explanations had no cultural resonance. The most poignant chapter concerns Hari, a “giant” whose madness according to Kakoli witnesses consisted of constant running over huge distances, strange speeches and occasional random acts of destruction such as chopping down trees and killing pigs. Goddard struck up a friendship of sorts with Hari based on a mutual love of marathon running. As he learns more of Hari’s history, Goddard comes to realize that the Kakoli imagining of his madness derived primarily from Hari’s status as an outsider unafraid to voice criticisms of his society and unwilling to fulfill obligations to kin and neighbours. As Goddard vividly puts it, the social “construction of kekelepa Hari was a communal exercise in moral iconography” (144).
The book concludes with brief but fascinating thoughts on how various engagements with Western institutions, especially Christianity, may be leading the Kakoli to a conception of personhood in which psychiatric explanations of madness make sense. The chief value of Out of Place, however, resides in its ethnographic contribution: a compelling witnessing from the field that powerfully challenges conventional thinking underlying a global discipline of mental health.
John Barker
The University of British Columbia, Vancouver, Canada
p. 696