Patients and Agents

The result of two years of intensive fieldwork in Bangladesh, this book looks at ideas and experiences of mental illness in the Sylhet community. Madness (by local definition) is common; the author considers how this fact may relate to the pressures of rapid modernization. As a female fieldworker, many of her informants were women; the author also believes the pressures in Sylhet are particularly difficult for newly-married women. Alyson Callan was a psychiatrist when she undertook this research for her PhD in anthropology, but in the book she acts as an anthropologist, following Sylhet rather than Western ideas of madness. The book begins with a chapter on social change in the area. There follows an outline of the ethnopsychiatry of Sylhet, and chapters on the relationship between madness and religiosity, on sorcery, and on marriage and the ways madness operates to offer resistance in difficult situations. Callan also looks at how definitions of madness interact with spirit possession, personal choice, and the will of Allah (Sylhet is a Muslim region). She considers Muslim patients with Hindu healers, and the role of female saints. In her conclusions, the author points out that patients have much agency, though it is constrained by the systems they are in. Callan's data refutes simplistic interpretations: Western biomedicine does not destroy native systems of treatment, men's and women's experiences of madness are neither the same nor opposite, Islam and modernization are neither positive nor negative forces in the lives of women. The author points out that tradition and modernity are not opposing forces, and while these forces are never neutral, they operate in all directions. Callan writes extremely well in an engaging first-person style, and the book will interest general readers who wish to know more about mental affliction, spiritual belief, medicine, life in Bangladesh, or modernization. Annotation c2012 Book News, Inc., Portland, OR (booknews.com)

Alyson Callan is a psychiatrist and anthropologist. She currently works as a consultant psychiatrist in Brent for the Central and North West London NHS Foundation Trust.