Of shifting economies and making ends meet: the changing role of the accompagnant at the Fann Psychiatric Clinic in Dakar, Senegal

Falling, Dying Sheep, and the Divine: Notes on Thick Therapeutics in Peri-Urban Senegal

Peri-urban Senegal lies outside the influence of both the nation's historic public mental health model and contemporary global mental health. This paper examines how cultural logics in this underserved region spill over from social domains to widen the therapeutic sphere of psychoses and epilepsy. Observations and 60 carer and/or patient interviews concerning 36 patients afflicted by one or both conditions illustrate how the "crisis of the uncanny", a spectacular eruption of psychoses and seizures into the everyday, triggers trajectories across these domains. To resolve the crisis, patients and carers mobilize debts and obligations of extended kin and community, as well as a gift economy among strangers. The therapeutic and non-therapeutic are further linked through the semantics of falling, which associates this local term for the crisis with divine ecstasy and the slide from human to non-human forms of life. We introduce the concept of thick therapeutics to capture how the logics of sheep- other animal-human relationality, secular-divine politics of giving, and payment/sacrifice for healing imbue a therapeutic assemblage continually constructed through actions of patients, carers and healers. We ask what implications therapeutic thickening might have for mental health futures, such as monetized payment under global mental health.

Henri Collomb and the emergence of a psychiatry open to otherness through interdisciplinary dialogue in post-independence Dakar

During decolonization, Henri Collomb was appointed to the first Chair of Psychiatry at the University of Dakar. Using a neuropsychiatric approach, he quickly made significant advances in the field, despite the colonial era's poor legacy of assistance facilities for mentally ill people. Through alliances with professors and researchers from the university Departments of Psychology and Sociology, an original interdisciplinary dialogue was set up to build up a research team which would develop rich and varied activities in the fields of transcultural psychiatry, medical anthropology and psychoanalytic anthropology. The methodological and theoretical contributions of such an approach are well illustrated in the book Œdipe africain by M-C and E Ortigues and in the journal founded in 1965, Psychopathologie africaine.