|
|
‘Mazombismo’ and the Paradoxes of ADHD Discourse and Practice in Brazilian Psychiatry
| Since the turn of the 20th century, Brazilian psychiatrists have maintained a position of reserved scepticism with regards to the importation of foreign-derived science and medical practice. Official accounts of the history of Brazilian psychiatry and psychology are imbued with understandings of various foreign “inventions” -- from intelligence tests in the 1930s to the codification of attention-deficit-hyperactivity disorder in the 1980s -- as “constructionist” symbols of global biopsychiatric Anglo-scientific intrusion. This scepticism has its origins in a century-long psychoanalytic tradition and more recently, a psychiatric de-institutionalization movement (1980s-) that has been critical of, but also incorporated, psychoanalytic orientations into what has now become a context-sensitive form of social psychiatry. At the same time, the 1990s and 2000s witnessed a significant rise in scientists’ use of biopsychiatric diagnostic technologies including, most notably, those associated with the creation of Attention-Deficit/Hyperactivity Disorder (ADHD). Whilst some psychiatrists and psychologists continue to avidly debate the perils of standardization and medicalization, the pharmacological treatment of ADHD has also increased significantly in the past decade, a development that puzzles and disheartens key leaders of psychiatric reform. For some of these leaders, this paradoxical situation is prototypically representative of professional mazombismo, a concept introduced into everyday professional debate in the 1950s by Brazilian historians of medical science and education that refers to the intellectual’s ambiguous drive to both rebuke colonial impositions and recreate Brazilians professional identity in the image of the colonizers. Based on historical and long-term ethnographic research carried out in Pelotas, a small town in Southern Brazil with a vibrant psychoanalytic psychiatric culture, this paper traces these historic underpinnings in an effort to explain first, psychiatrists’ persistent ideological resistance to the normalizing effects of biopsychiatric technologies ADHD, and second, the reasons for the failures of this resistance as these relate to the institutionalization of contemporary practices and therapeutic norms in both the health and primary educational systems. It will be argued that whilst the concept of mazombismo offers critical insight into the some of the classist limitations of Brazilian psychiatry, it also functions as an explanatory trope that discourages local therapists from engaging with the historic and contemporary forces accounting for the clinical and pedagogic institutionalization of normalizing biopsychiatric models of child development.
|
|
