One set of ideas that I initially brought to this work and that I briefly explore here concerns a person’s “plastic power.” “I mean,” wrote Friedrich Nietzsche in The Use and Abuse of History, “the power of specifically growing out of one’s self, of making the past and the strange one body with the near and the present, . . . of healing wounds, replacing what is lost, repairing broken molds” (1955:10, 12). Rather than speaking of an essential individuality or of an all-knowing subject of consciousness, Nietzsche calls our attention to modifications in subjective form and sense vis-à-vis historical processes and the possibilities of establishing new symbolic relations to the past and to a changing world.
Such plasticity—whether we think of it as the capacity for being molded or the adaptability of an organism to changes in its environment—is a theme moving through readings of anthropology, psychoanalysis, psychiatry, and cultural history. It appears in the “allo-plastic” capacity of Sigmund Freud’s neurotic patients to alter reality through fantasy (in contrast to “auto-plastic” psychotics) (1959b:279); in Bronislaw Malinowski’s argument about the “plasticity of instincts” under culture (as an alternative to the notion of a mass psyche) (2001:216); in Marcel Mauss’s ensemble of the social, the psychological, and the biological, “indissolubly mixed together,” in “body techniques” (1979:102); in the intrasocial and intersubjective debate that Gananath Obeyesekere regards as the “work of culture” (1990); in Arthur Kleinman’s reading of patterns of social and moral upheaval in individual symptoms of distress (1981; Kleinman and Kleinman 1985); in Nancy Scheper-Hughes’s account of the medicalization of the bodily common sense of “nervoso” alongside hunger (1992); in the body of the old person becoming an “uncanny double” in the liminal space between households and the science of old age, as evidenced by Lawrence Cohen (1998:269); and in the self-empowerment afforded to the subjected by ambiguity, as Judith Butler (1997) argues in The Psychic Life of Power. The notion of the self as malleable material runs through these otherwise divergent arguments; it is central to our understanding of how sociocultural networks form and how they are mediated by bodily affect and the inner world.7
A related literature expands this theme of malleability, finding it not so much in particular persons as in the plasticity of reality as such—that is, synthetic frameworks mediate social control and recast concepts of a common humanity. Theodor Adorno, for example, politicizes Freud’s group psychology model and argues that the peculiarity of modern authoritarian ties lies not simply in the recurrence of primordial instincts and past experiences but in their “reproduction in and by civilization itself” (1982:122; my emphasis). According to Adorno, Nazi science and propaganda created new mechanisms of identification that bound German citizens together, and against outsiders, in a state of moral blindness. Modern subjective reassemblage goes hand in hand with rational-technical politics and state violence.
In “Colonial Wars and Mental Disorders,” Frantz Fanon (1963) identifies and critiques the colonized subjectivity of the Algerian people under French imperialism. From Fanon’s perspective, the locus of imperial control is not necessarily the political and economic institutions of the colonizer but the consciousness and self-reflective capabilities of the colonized.8 Subjectivity is a material of politics, the platform where the agonistic struggle over being takes place. He states: “Because it is a systematic negation of the other person and a furious determination to deny the other person all attributes of humanity, colonialism forces people it dominates to ask themselves the question, constantly, ‘In reality, who am I?’” (1963:250). Fanon’s answer is one of deconstruction: whose reality?
Fanon rethinks Freud’s characterization of psychotic experience as being cut off from reality and being incapable of achieving transference.9 Rather than excising the psychotic from the possibility of treatment, Fanon is concerned with the mechanisms by which the reality that the psychotic patient appears unable to grasp has been effected. In dealing with psychosis, Jacques Lacan also urges psychiatrists and psychoanalysts to question their own trust in the order of reality (1977:216), to halt diagnosis, and to let patients define their own terms.
“There is intuitive intelligence, which is not transferable by speech,” said a patient in a conversation with Lacan. “I have a great deal of difficulty in logifying. . . . I don’t know if that is a French word, it is a word I invented” (1980:27). We are here faced with the patient’s making of meaning in a clinical world that would rather assign such meaning (see Corin 1998; Corin, Thara, and Padmavati 2003). We are also faced with Lacan’s important insight (drawn not only from intellectualization but also from his psychoanalytic practice)10 that the unconscious is grounded in rationality and in the interpersonal dimension of speech: “It is something that comes to us from the structural necessities, something humble, born at the level of the lowest encounters and of all the talking crowd that precedes us . . . of the languages spoken in a stuttering, stumbling way, but which cannot elude constraint” (1978:47, 48). For Lacan, subjectivity is that failed and renewable and all too human attempt to access the truth of oneself.11 As I listened to Catarina, I saw a picture of social life emerging as agonizing and uncertain, as order and chaos, as it was actually lived.
Through and beyond subjective recollection and archival representations, my ethnographic work approached the stubborn (though ambiguous), concrete, and irreducible experience of Catarina’s being in relation to others, to what was at stake for them in her vanishing from reality, and to what counted for her now (Kleinman 1999; Das 2000). In her own words:
I know because I passed through it
I learned the truth
And I try to divulge what reality is
It was not a matter of finding a psychological origin (a thing I don’t think exists) for Catarina’s condition or solely of tracking down the discursive templates of her experience. I understand the sense of psychological interiority as being ethnological, as the whole of the individual’s behavior in relation to his or her environment and to the measures that define boundaries, be they legal, medical, relational, or affective. It is in family complexes and in technical and political domains, as they determine life possibilities and the conditions of representation, that human behavior and its paradoxes belong to a certain order of being in the world.12
How does one become another person today? What is the price one pays? How does this change in personal life become part of memory, individual and collective? By way of her speech, the unconscious, and the many knowledges and powers whose histories she embodies, there is the plastic power of Catarina as she engages all this and tries to make her life, past and present, real, both in thought and in writing.
In working with Catarina, I found Byron Good’s study of epidemic-like experiences of psychoses in contemporary Indonesia particularly illuminating (2001). While directing attention to how the experiences of acute brief psychoses are entangled with the country’s current political and economic turmoil, the ghostliness of its postcolonial history, and an expanding global psychiatry, Good emphasizes the ambiguities, dissonances, and limitations that accompany all attempts to represent subjectivity in mental illness. He suggests three analytic moves: the first, working inward through cultural phenomenology to discover how the person’s experience and meaning-making are woven into the domestic space and its forceful coherence; the second, bringing to the surface the affective impact and political significance of representations of mental illness and subjectivity; and the third, interpreting outward to the immediate economic, social, and medical processes of power involved in creating subjectivity.13 Good unremittingly resists closure in his analysis, challenging us to bring movement and unfinishedness into view.
As Catarina and I disentangled the facts of her existence, both the ordinariness of her abandonment and the ways it was forged in the unaccounted-for interactions of family, psychiatry, and other public services came into view. In the process, I also learned that the overpowering phenomenology of what is generally taken and treated as psychosis lies not in the psychotic’s speech (Lacan 1977) but in the actual struggles of the person to find her place in a changing reality vis-à-vis people who no longer care to make her words and actions meaningful. Catarina’s human ruin is in fact symbiotic with several social processes: