despedida a puebla

another summer in Puebla draws to its end, students are back at the School of Medicine, in their white coats and shoes, buying textbooks and registering for coveted classes. I return to Eugene to the task of developing my book manuscript during a much-needed no-teaching term this fall. As always, the work I do with MHIRT in Mexico continues to inform my conception of mental health, illness, culture, psychiatry, and contemporary globalization. In a compelling 1997 article in Transcultural Psychiatry, Gilles Bibeau argued that, to remain relevant to contemporary globalization, anthropologists working on issues of mental health need to hone their conceptualizations of both culture and of mental illness. He proposed that notions of borders, margins, and paradoxes are most useful in our conceptual toolkit, for they help us make sense of “the transitional stage in which most individuals and societies find themselves…living at the interface of local and global worlds, torn between multiple attachments and … the necessity to assume a more flexible pluralist frame of reference in the shaping of a larger world” (Bibeau 1997:10). In thinking about several interviews with psychiatric patients this summer and last, this quote is incredibly apropos to their situation. For instance, in one case – that of a 40-something year old man, he attributed his psychosis to a period of unemployment that followed nearly a decade of work as an upper-level manager for a major multinational firm in Puebla, which shut its doors in the late 90s partially as a result of NAFTA’s effects on the Mexican economy; in another – that I describe below – a 20-something woman attributes her major depression and anxiety to the rifts that have formed between herself and her parents around her gender identity, desire for independence, and rejection of “traditional” female gender roles. There are many other cases to mention, including that of a 20-something year old university student who told us that his first major depressive episode was a result of the “shock” of moving to Puebla (city) from a small pueblo, which he describes as like a “boom” (his word) of cultural change, which drastically reshaped his sense of self and social relationships. I can also apply Bibeau’s insights to my own lived experience of Puebla, a city that is as “traditional” (in its centro histórico, with its zócalo, iglesia, cafés, artesian shops, narrow streets, and 18th-century tiled buildings) as it is “modern” (in its zona Angelópolis, filled with multi-lane freeways, track housing developments, huge shopping centers, and chain stores like Costco, Mega grocery store, and import car dealerships). Moving around the city everyday, it’s hard not to feel the city as caught between the historical tensions of Mexican development and national identity; further, I often think in a city such as this, where the “traditional” and “modern” coexist and clash, how much sense disorders such as major anxiety and schizophrenia actually make – they seem apt embodied expressions of the state of this particularly unruly social and cultural world. 


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