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The Zone of Social Abandonment in Cultural Geography: On the Street in the United States, Inside the Family in India

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Abstract

This essay examines the spaces across societies in which persons with severe mental illness lose meaningful social roles and are reduced to “bare life.” Comparing ethnographic and interview data from the United States and India, we suggest that these processes of exclusion take place differently: on the street in the United States, and in the family household in India. We argue that cultural, historical, and economic factors determine which spaces become zones of social abandonment across societies. We compare strategies for managing and treating persons with psychosis across the United States and India, and demonstrate that the relative efficiency of state surveillance of populations and availability of public social and psychiatric services, the relative importance of family honor, the extent to which a culture of psychopharmaceutical use has penetrated social life, and other historical features, contribute to circumstances in which disordered Indian persons are more likely to be forcefully “hidden” in domestic space, whereas mentally ill persons in the United States are more likely to be expelled to the street. However, in all locations, social marginalization takes place by stripping away the subject’s efficacy in social communication. That is, the socially “dead” lose communicative efficacy, a predicament, following Agamben, we describe as “bare voice.”

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Notes

  1. There does appear to be an informal substitute-kin system among those of the well who wander (Anderson and Rauty 1999).

  2. The NIH funded project was carried out by Tanya Luhrmann with the help of five able students: Amy Cooper, Johanne Eliacin, Jim Goss, Barnaby Reidel, and Kim Walters.

  3. However, see Pinto 2011, p. 391 where she reconsiders the ward as a place of social death. She writes: “Rather than a ‘zone of social abandonment’…[the ward] was a space of relation unmaking, an extension of ongoing—and very human—kin-work.”

  4. All names are pseudonymous.

  5. In a door-to-door survey conducted by Carstairs and Kapur in Kerala the early 1970s, the odds ratio for persons with any significant psychiatric symptoms was .5 males to females. If, in the early 2000s, women were still twice as likely to suffer psychiatric symptoms than men, then Marrow’s study suggests symptomatic women are only 25 % as likely to receive treatment as men. In Marrow’s sample, the odds ratio of males to females with psychosis was 2.35, with 40 men diagnosed with psychotic disorders compared to 17 women. This odds ratio matches that of Carstairs and Kapur’s 2.35. However, Carstairs and Kapur’s study found only a total of ten psychotic subjects—three women and seven men. In contrast, Ajita Chakraborty’s door-to-door survey in Calcutta during the late 1970s found an odds ratio of .46 males to females suffering psychosis.

  6. The DOS study classified the following countries as “developing:” Ibadan, Nigeria; Cali, Columbia; Agra, India; urban Chandigarh, India; and rural Chandigarh, India. The “developed” countries were as follows: Aarhus, Denmark; Dublin, Ireland; Honolulu and Rochester, USA; Moscow, USSR; Nottingham, UK; and Prague, Czechoslovakia. Among the developing countries sampled, over 49 % of subjects recruited to the study lived in North India—Agra and Chandigarh—calling into question whether the North Indian data is overrepresented in the picture of the course and outcome of schizophrenia for the developing world in general.

  7. We owe this phrase to Martha McClintock of the University of Chicago.

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Acknowledgements

Jocelyn Marrow’s field research was supported with a Junior Fellowship from the American Institute of Indian Studies and a Fulbright-Hays Doctoral Dissertation Research Award; research with human subjects was approved by the University of Chicago’s Institutional Review Board. Much gratitude is due to her research subjects, the institutions that allowed her to conduct research, her assistant, Sanghamitra Sarkar, M.A., and her research guides at Banaras Hindu University: Professor Anjoo Sharan Upadhyaya, Ph.D. and Professor Indira Sharma, M.D. Tanya Marie Luhrmann’s research was supported by a grant from the National Institutes of Health. She is grateful to the students who participated in that project (Amy Cooper, Johanne Eliacin, Jim Goss, Barnaby Reidel and Kim Walters) and above all to the clients and staff who spoke with her in Uptown.

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Marrow, J., Luhrmann, T.M. The Zone of Social Abandonment in Cultural Geography: On the Street in the United States, Inside the Family in India. Cult Med Psychiatry 36, 493–513 (2012). https://doi.org/10.1007/s11013-012-9266-y

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