Experiments in Scale: Humanitarian Psychiatry in Post-Disaster Turkey

ABSTRACT

A massive earthquake that struck Turkey in 1999 generated an unprecedented mobilization of Turkish psychiatrists and psychologists to address the mental and emotional aftermath of the disaster. In this article I examine how these mental health professionals, swept up in a wave of humanitarian compassion, confronted the limits of their own expertise and struggled to improvise a therapeutic response that could match the scale of psychological suffering precipitated by the earthquake. Framing humanitarian and global health interventions as inescapably scalar projects, I explore the pragmatic and imaginative labor involved in making psychiatric expertise scalable, what I characterize as their “work of therapeutic scalability.” In doing so, I raise a series of questions about the psychological subject of disaster, the transnational mobility of technoscientific expertise, and the politics of both life and scale at play in psychiatric humanitarian intervention.

KEYWORDS:

• Turkey
• disaster
• earthquake
• humanitarian psychiatry
• expertise
• scale and scale-making

Acknowledgments

This project has accumulated many debts along the way. For this article, I am grateful to the psychiatrists and psychologists who were willing to be interviewed. I thank Kerim Munir for his encouragement and the initial connections he offered. I deeply appreciate the support from Tamer Aker, Bülent Coşkun, Meltem Kora, and Deniz Yücelen. An early version of this was presented at the Critical Research on Culture, Psychiatry, and Mental Health Service Conference at Harvard University, and I thank the organizers, Byron Good and Mary-Jo DelVecchio Good. They have provided me with remarkable support across the years. I also appreciate the incisive feedback from Lenore Manderson and the anonymous reviewers.

Notes

1. Unless otherwise noted, I will follow popular convention by using “earthquake” in the singular when referring to the two seismic events of 17 August and 12 November 1999.

2. All names are pseudonyms.

3. Artvınlı’s illuminating examination of the history of psychiatry in Turkey demonstrates the specific influence of Emile Kraepelin and his followers on early psychiatry in Turkey, a trend that continues into the present (Artvınlı 2014). See also Narter (2006), Behmoaras (2001), and Öncüler (2013). For a broader anthropological engagement with the assumptions of biological psychiatry, see Kleinman (1988), Gaines (1992), Good (1992), Luhrmann (2001).

4. See, among many others, the work of Young (1995), Leys (2000), Breslau (2000), Fassin and Rechtman (2009).

Additional information

Funding

This research was supported by a grant from the Amherst College Faculty Research Award Program, as funded by The H. Axel Schupf '57 Fund for Intellectual Life.

Notes on contributors

Christopher T. Dole

Christopher T. Dole is a Professor of Anthropology at Amherst College and the director of the Five College Program in Culture, Health and Science. He is the author of Healing Secular Life: Loss and Devotion in Modern Turkey (2012) and co-editor of The Time of Catastrophe: Multidisciplinary Approaches to the Age of Catastrophe (2015).