« Moi-même je ne connais pas mon histoire »

Quote and photo from the field. By ESR Annigje van Dijk

Figure 1 Entrance of the psychiatry ward of Ouagadougou's main hospital.

All ESR's are on fieldwork in Africa in 2019. As part of the dissemination they will be sending a photo and a quote from the field while they are away.   

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This photo and quote from the field comes from ESR Annigje van Dijk who is doing her fieldwork in Burkina Faso on the lived experiences of people with mental illness . Read more about her research here.

I myself don’t know my story”, was Daniel’s[1] reaction after I had tried to explain him my research – which is about the lived realities and trajectories of people with episodes of mental troubles and those closely related to them in Ouagadougou. We were sitting in front of the room of the psychiatric ward of Ouagadougou’s main hospital where he is currently staying, accompanied by his mother[2]. In my explanation I had told him that I am a researcher interested in getting to know the stories of the people staying in the hospital. Part of my intention was to put him in the position of “expert” – who would know his story better than himself? – but instead he returned the question: “How do you explain all this?”.

This exchange and other conversations that I had with people in the hospital show one of multiple factors of uncertainty posed by mental troubles (or ‘madness’): it is hard to make sense of the experience, for patients as well as their relatives. Those who come to the hospital get medication to attenuate their symptoms, but following a biomedical treatment does not in itself provide a narrative, and psychotherapy is not available for everyone. Each individual story holds different elements – like family problems, drug use, magic, abandonment, spirits, death, failure, stress, deception, religious conflict and more – that can either individually or in combination be seen as explanations. Understanding matters for how people see themselves, act upon their troubles and perceive possibilities for healing (through psychiatry, prayer, traditional healing or combinations) as well as for how they relate to each other. Life in the hospital is marked by taking medication and side effects, but also by prayer, discussions, boredom, thinking, as well as by negotiations in the relations between patients and their accompagnants, that often contain care, anger, sadness, love, blame, worry, frustration, sometimes violence… Not understanding one’s experience is a factor of uncertainty, and in addition not understanding each other can sustain tension, create conflict and even maintain mental troubles. As another young man in the hospital said: “according to me, people are mad when those around them don’t understand them anymore”.

Having all of the above in mind, Daniel’s question put me in a difficult position. Whereas I would like to help him understand his story, I was myself very uncertain about how to interpret all the different elements that had surfaced in our conversation about his life. After three-and-a-half months of engaging with a multiplicity of stories, struggles and explanations about mental troubles I often feel confused rather than knowledgeable. I certainly did not see myself fit to speak from the ‘expert’ position Daniel seemed to put me in and honestly told him that I was also still searching.

 


[1] This is a pseudonym.

[2] Patients do not stay alone in the hospital. There is at least one person – most often a member of their family – who stays with them to take care of their needs. This person is referred to as accompagnant.