Jack R. Friedman

“A world crazier than us”: Vanishing social contexts and the consequences for psychiatric practice in contemporary Romania:

Since the end of Communism, mental health care in Romania has increasingly sought to align its practices with idealized models of Western psychiatric practice. Much of this realignment has been made possible by accessing and integrating new pharmaceuticals into psychiatric hospital settings. Less straightforward have been the painful attempts to create a system modeled on international standards for training and certifying psychotherapists. Unfortunately, the political, economic, infrastructural, and epistemological environment of the Romanian mental health care system has prevented many other reforms. This paper examines the ironic trajectory that Romanian psychiatry has taken since the end of state socialism. Specifically, this paper shows how psychiatric practice in most places (outside of university-training hospitals) is increasingly disconnected from a concern with the social conditions that surround mental illness during a period when social upheaval is profoundly impacting the lives of many people who receive mental health care. Thus, as the contribution of social problems to the suffering of those with mental illnesses has increased, some Romanian mental health practitioners have moved away from a concern with these social problems under the guise of aligning their psychiatric practices with (imagined) Western standards of biomedical care. The paper provides a brief history of Romanian psychiatry and explores contemporary challenges and contradictions in many Romanian psychiatric treatment settings through the case study of a 31-year-old Romanian female diagnosed with paranoid schizophrenia.

Introduction: The Person in Politics and Culture

Drawing together psychological anthropology and the study of political subjectivity, Friedman and Strauss explore how politics becomes part of who we are. Tracing an arc from theories of culture to theories of subjectivity, the chapter argues for the special value of a person-centered research approach that will allow theories of political subjectivity to be built up from the individual. This chapter examines a number of critical questions that are explored throughout this volume: What is the role of emotions in politics? How are political messages taken up by the public? What are the subjective consequences of conflicting political discourses? How do people’s identities relate to politics? What are the subjectivities of political bystanders? How do people become politically active? How do we explain populist politics?

Feeling Populist: Navigating Political Subjectivity in Post-socialist Romania

Drawing on Laclau, this chapter examines the emergence of populist political subjectivity in Romania’s Jiu Valley coal mining region. Contrasting data gathered over a decade, during which the Jiu Valley increasingly lost social stability, economic security, and political influence, Friedman shows how political subjectivity can change over a relatively short time, describing how people in the region had, in an earlier period, relied on state socialist-era ideological cultural models that equated hard work and sacrifice with entitlement to recognition. As they became marginalized from political power in Romania, the sharing of discrete and different experiences of suffering, decline, humiliation, and the loss of agency became part of, what Laclau terms, a “chain of equivalence” that resulted in the rise of populist political feelings and subjectivities.

The Experience of Cancer in American Indians Living in Oklahoma

Many cancers in American Indians (AIs) are not diagnosed early leading to effects on physical, social, and emotional well-being or quality of life (QOL). Little research has been done on QOL of AIs in Oklahoma. This study examined the experience of living with cancer of AIs in Oklahoma to gain greater understanding of QOL issues and provide a basis for interventions to improve QOL. Twenty AIs diagnosed with cancer and receiving care in Oklahoma participated in this pilot study through semistructured interviews. Data were analyzed using thematic analysis. Themes identified included circles of support, finding meaning in the experience, and facing personal challenges such as health care–related issues, including mental health needs and fragmented care. The findings from this pilot study provide insights into the cancer experience of AIs in Oklahoma and demonstrate that care navigation and social support are important aspects to address in intervention development.