When Nancy Scheper-Hughes’s Saints,
Scholars, and Schizophrenics: Mental Illness in Rural Ireland first
appeared in 1977, it attracted immediate attention on both sides of the
Atlantic. But despite being widely
celebrated in North American anthropological circles, it shocked and outraged
many of those who were its subjects: the residents of the tiny village of An
Clochán on western Ireland’s Dingle Peninsula. 
They took offense at what they perceived as a breach of trust, an
illicit airing of secrets about their sexuality, mental and emotional health,
and family life which they had confided in strictest confidence. Now, more than 25 years after the conclusion
of her fieldwork, Scheper-Hughes is still attempting to resolve the conflict
between her professional duties as a psychological anthropologist and her
personal responsibility toward her friends in An Clochán. In her new prologue and epilogue, written
especially for this 20^th anniversary edition, she confronts this
conflict in an eloquent discussion which touches on issues of philosophical
importance to the field of anthropology while highlighting the development of
her own relationship to her work and the subjects of that work in the
intervening years. The quality and
substance of these added sections make this justifiably classic work even more
valuable to scholars and interested laypersons alike.

The subject of Scheper-Hughes’s
book alone would be enough to raise eyebrows in some circles: it is an attempt
at “a broad cultural diagnosis of those pathogenic stresses that
surround the coming of age in rural Ireland” (60) and that, in her opinion,
contribute to an extremely high incidence of schizophrenia in the country’s
western counties. This tendency is
especially pronounced among the area’s young and middle-aged “bachelor
farmers,” the men who have been subtly coerced by their families into remaining
in the village of their birth and taking over their fathers’ farms in an age
where farming has lost its once high status as a profession and has become economically
unprofitable in all but a very few cases. 
The breakdown of the traditional extended family structure, along with
the emigration of many of the eligible young women from rural Irish villages,
has resulted in these men living lives of social isolation, loneliness, and
mostly unwanted celibacy. More than
even this unfulfilling lifestyle, however, the brutal socialization process, in
which the perceived “runt” of a family is demoralized, scapegoated, and made to
feel overwhelming guilt if he refuses to remain at home to tend to his aging
parents and inherit the family farm, is singled out by Scheper-Hughes as
leading to the emergence of schizoaffective symptoms.

In her analysis, Scheper-Hughes
draws on several different methodologies, ultimately developing a new and
fruitful paradigm for fieldwork in psychological anthropology. She attempts to strike a balance between a
thoroughly medical view of schizophrenia, in which it is regarded as a
personal, inner disorder – whether organic or psychical in nature – and an
interactionist perspective that situates it in the relationship of the
individual to her community and surroundings. 
In addition, she emphasizes the significance of cultural and historical
analysis to the interpretation of mental illness. In her introduction, “Mental Illness and Irish Culture,” she
situates her work within the “culture and personality” school, whose most
celebrated adherent, Margaret Mead, revolutionized anthropology with her focus
on the role of an individual’s culture in the development of her
character. By trading statistical
analysis and cross-cultural hypotheses for intensive, immanent study of a
single community, Mead ignited a profound and still unsettled methodological
debate within cultural anthropology. 
However, despite her debt to this school, Scheper-Hughes balances her
subjective observations of life in An Clochán with analysis of the responses of
several dozen youth to the Thematic Apperception Test (TAT) – a sample which
included both “normal” village youth and young patients at the district mental
hospital and a local psychiatric clinic. 
The two approaches combine to give an extremely revealing view not only
of the etiology of schizophrenia in rural western Ireland, but of the often
pathogenic social and cultural dimensions of life in An Clochán and,
presumably, other villages like it.

Cloaking the true name of the
village under the moniker “Ballybran,” and referring to the villagers, or
“parishioners,” with pseudonyms, Scheper-Hughes attempts to afford them a
modicum of privacy while describing their intimate relations in great
detail. The complete failure of this
strategy – not only were the villagers able to identify each other instantly
upon reading the book, but the identity of the village itself was also
eventually discovered by persistent researchers and curiosity-seekers –
illustrates what is at once the greatest failing and one of the most intriguing
aspects of this masterful and eloquent study. 
Despite her extremely keen understanding of the social dynamics of the
community in which she was immersed, Scheper-Hughes was ultimately unable to
negotiate the Irish need for privacy, to reconcile it with her commitment to
the demands of anthropological fieldwork and analysis. For that need could not be met by the
marginal anonymity afforded by pseudonyms; the very fact that their innermost
fears and desires were committed to print at all, however, anonymously, is what
so shocked and angered the villagers. 
Thus a standard of privacy that would perhaps suffice for a resident of
a large North American city was considered a betrayal of trust in tiny An
Clochán.

The intimacy of the study was
necessitated by Scheper-Hughes’s concentration on family relations, which she
sees as profoundly implicated in the emergence of schizophrenia among the
community’s most vulnerable members. 
Before her analysis of family structure and socialization, however, she
first gives an “ethnohistory” of An Clochán, a reconstruction of its mythic
past from stories told about its founding by seafaring Celts and subsequent
conversion to Catholicism by Saint Brendan. 
She goes on to consider the changing demographic and economic patterns
within An Clochán, most predominantly the emigration of many of its young women
and firstborn sons and the devaluing of the traditional family farming
lifestyle in the light of insurmountable competition from large international
collectives. These two developments
have resulted in a widespread demoralization or anomie within the
segment of the population that has been “left behind” in the village,
especially its bachelor farmers, who are most directly affected by both. Finally, Scheper-Hughes turns to
conventional epidemiological data to elaborate on the distribution of mental
illness in rural western Ireland. 
Through consideration of variables such as gender, marital status, and
birth order among hospitalized patients, she bolsters her argument that it is
precisely those “discarded” late-born sons and potential farm heirs who are at
greatest risk of developing schizophrenia and other forms of serious mental
illness. Weaving a discussion of the
attitudes of the villagers toward various forms of unconventional behavior into
the analysis, she simultaneously illustrates their predilection toward labeling
this group “abnormal” and institutionalizing its members when they rebel
against their prescribed societal role.

In
the final three chapters of the book, Scheper-Hughes focuses on family
relations, in particular those between mothers and children. Here she presents the material that aroused
the most ire among the parishioners of An Clochán, particularly in Chapter 4,
“Brothers, Sisters, and Other Lovers,” where she describes what she
characterizes as a climate of fear and mistrust between the sexes, an antipathy
toward marriage, and a seeming rejection of adult conjugal relationships in
favor of brother-sister and mother-son relations with repressed incestuous
undertones. After this analysis, she
shift her focus to the socialization process which she believes produces
schizophrenic potential farm heirs and anomic bachelor farmers – a process
which she characterizes as being “weighted in favor of the mental health of
daughters and earlier-born sons, and against the chances of healthy ego
integration of later-born sons” (267). 
She details a pattern which includes minimal contact as an infant,
corporal punishment, and most tellingly, the chronic discouragement and
humiliation of those sons considered to be, by their very nature, unsuitable
for anything other than remaining at home to tend their aging parents in and
inherit the family farm. This labeling
process, by means of which the most psychologically vulnerable member of the
family is forced into the role of underachieving “black sheep,” encompasses not
only the immediate family, but also schoolteachers, peers, and the community in
general, and is for Scheper-Hughes profoundly psychogenic.

It is clear throughout Saints,
Scholars, and Schizophrenics that Scheper-Hughes reflected profoundly on
the social and sexual dynamics of the people among whom she lived, and with
whom she developed a bond of friendship. 
Despite her almost complete immersion into village life, however, it
appears that this reflection did not extend to a consideration of the effects
of her work on her neighbors and friends. 
At the end of her original introduction, she states that “I trust [the
villagers] realize that although I stress some of the more dismal aspects of
their life . . . they will accept the large measure of my concern for their
physical, emotional, and spiritual well-being” (75). Seen from the perspective of current anthropological paradigms,
such confidence seems impossibly naïve, perhaps a consequence of wishful
thinking. Despite the great care she
takes to divorce her analysis from the influence of cross-cultural norms, in
the end she draws her conclusions about how the villagers will react to her
work on her own terms, not those of An Clochán. This may very well be an almost unavoidable consequence of the
anthropologist’s position, and indeed of human subjectivity in general, but its
universality renders it no less problematic. 
Rather, it calls into question the ethical status of anthropological
fieldwork, forcing sensitive and perceptive researchers such as Scheper-Hughes
to reflect profoundly on their human as well as scientific failings. Thus, if the book exposes the dark secrets
of the residents of An Clochán, it also affords the reader an intimate glimpse
of the author’s biases, uncertainties, and weaknesses.

This unusual personal dimension
gives Saints, Scholars, and Schizophrenics an appeal beyond that of
ordinary accounts of anthropological fieldwork, an appeal that is intensified
by the apologietic and self-reflective material which has been added for this
new edition. Given that Scheper-Hughes
herself now acknowledges the problematic nature of her original analysis and
attempts to make amends, it is difficult to take her to task for it, especially
since the work is otherwise so thoughtfully executed. In her new epilogue, “Crediting An Clochán” – a title undoubtedly
inspired by one villager’s complaint that “ya just didn’t give us credit”
(311) – she details the high status of women in the village, the nonexistence
of crime, and the warmhearted way in which she was integrated into the
community upon her arrival 1974. Realizing
that it is impossible “to diagnose just what ails a community and then
prescribe a few magic, silver-bullet solutions” (20-1), she speculates in the
prologue “Writing Ireland” about her shortcomings as a researcher and friend,
many of which can be attributed to her understandably being unable, as a young
researcher doing her first significant piece of fieldwork, to recognize and
move beyond the flaws inherent in the anthropological paradigms of the
time. In confessing her sins, she, like
the residents of An Clochán in their weekly sessions with the village curate,
holds herself to an impossibly high standard. 

Despite having first appeared 25
years ago, Saints, Scholars, and Schizophrenics still feels remarkably
current, due not only to its methods, but also to the often philosophical
issues it raises, many of which are still very relevant today. The debate over the extent to which mental
or even physical illnesses are constructed by societal factors, for example,
has taken on a new intensity with the emergence of poorly-understood conditions
such as Attention Deficit Disorder and Chronic Fatigue Syndrome, and with
forensic psychologists regularly being accused of fabricating various “syndromes”
in order to help criminals escape conviction. 
The relativity of terms such as “deviant” or “sinful” is also becoming
increasing apparent as globalization brings cultures with diverse norms into
ever more frequent contact, and conflict, with one another. Finally, the forced institutionalization of
young people who refuse to take on a particular societal role finds analogues
in, among other places, current debates over a family’s right to choose to
remove a patient from life support when her wishes are not explicitly known.

Saints, Scholars, and
Schizophrenics exists at the nexus of anthropology, psychology, and
philosophy. This alone makes it highly
recommended for professionals in any of these fields who appreciate the
importance of both an interdisciplinary perspective and a personal investment
in scholarly work. In addition,
Scheper-Hughes writes with a lucidity that clarifies without oversimplifying,
rendering the work accessible to interested laypersons as well. Her starkly eloquent prose perfectly
reflects the intertwining of scientific rigor and personal insight so evident
throughout the book. Even – or perhaps
especially – those who were engaged by the first edition will find this new one
rewarding, for the insight, self-reflection, and philosophical inquiry
contained in the new prologue and epilogue constitute a truly substantive
addition. Most importantly, perhaps,
this book should be read because of its evolving history, its status as a work
in progress, representing not merely an account of research carried out during
several months in the mid-1970’s, but the ongoing engagement of a scholar with
her profession, her world, and herself.

©
2002 Gina Zavota

Gina Zavota, Department of Philosophy,
SUNY at Stony Brook

Categories: Philosophical, MentalHealth

Tags: Psychiatry, Schizophrenia