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Aidan Seale-Feldman, "The Work of Disaster: Crisis and Care Along a Himalayan Fault Line" (U Chicago Press, 2025)
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- [00:01]
A
Welcome to the New Books Network. Hello. Welcome to New Books Network. I'm Elena Sobrino and I am a host on the Anthropology Channel. And today I'm really excited to be talking to Aidan Seal Feldman about her new book, the Work of Crisis and Care along a Himalayan Fault Line. And this is new from University of Chicago Press. And we're going to talk about Aidan's fieldwork and the aspects of the book touch on the humanitarian making of crisis experience on the ground, the nuances and challenges of mental health in the context of disaster. And, yeah, it's super interesting. It's a great read. And I want to start out just by saying thank you for joining me today. And I'm wondering, first of all, what led you to write this book?
- [01:00]
B
Yeah, well, thank you so much for this invitation. It's always wonderful to get the chance to talk about your work, one's work. So, yeah, this book came about in a very unexpected way. I was conducting fieldwork in Nepal actually on basically spirit possession, conversion disorder, cases of mass hysteria among teenage girls. And I was really interested in the kind of translation of affliction between indigenous and psychiatric worlds. And so I was in Nepal, and I was in a village in the eastern hills following a case where a case of mass hysteria had happened. And I had been there a few months, and then suddenly this earthquake happened. And it was like I was just in the middle of this massive disaster, and the village was spared, but just on the edge of the affected zone. So it was. We really felt it, the first earthquake, there were two. And then at that point, it was like everything just shifted. I mean, it felt like I couldn't really continue the original work I was doing. I didn't really know what to do. And after kind of grappling with that for some time still in the village, I started kind of looking for ways to put my training to use and ended up working with an NGO for mental health and counseling. But I had already been working with prior to the disaster, but actually in the role of kind of doing engaged ethnographic field work. And then the project followed from there. So it was really. It came out of my own experience of living through the disaster and watching mental health kind of emerge as an important issue in the middle of my field work. So that's kind of the story.
- [02:50]
A
Yeah, no, it's super interesting, a really dramatic pivot. And I wanted to ask you a bit about that kind of entry of humanitarianism into Nepal into your own timeline, as it were. And I will say, reading this, I was just so struck by some of the things that sounded familiar about specifically the kind of disaster response kind of mechanisms. It felt very similar to things I'd seen in Flint as I did fieldwork about the Flint water crisis. And certain details just felt like they were almost identical. Likewise, after the water crisis, there were these kind of working group models that got set up. And I do remember there being a group dedicated to mental health. And I wasn't super involved with that directly necessarily, but I guess I'm just struck that you have an early chapter in this book about crisis. And I wonder if you could say a bit more about maybe what your take is on some of these humanitarian consistencies or, you know, this feeling that it feels very globalized and kind of almost prefabricated, and then it's kind of hitting the ground in this way that is very helpful, but also maybe very detached from kind of existing ways of going about things, if that makes sense. Like typical ways of responding to a disaster. But suddenly there's this model, working group model. So, yeah, I just wonder if you can say something about what you think of that aspect of humanitarianism and its implications for care. Yeah, I thought it was super interesting.
- [04:45]
B
Yeah, it's interesting to hear that there are similarities in Flint. I mean, one thing I can say is that the humanitarian apparatus is itself a globalist phenomenon. So one reason why things might look the same in different places is that you actually have the same organizations working in different places, sometimes the same people even. And I met people in Nepal who had worked in Sri Lanka after the tsunami, or they worked in Haiti, or they worked in different kinds of places, and they kind of touched down. So there is a lot of consistency even in the people themselves. And just some of the approaches are obviously taken into different scenarios as a sort of universal kind of approach, type of model. So I think that's probably the reason why. But I don't know what was happening in Flint. I mean, the working group thing I actually found interesting in Nepal because in some ways it was like there was this interest in talking about mental health. And it came to be this fleeting space where people came together to try to imagine Nepal's mental health future. So in some ways that was a very exciting kind of outcome. But on the other hand, the types of futures that were imaginable were predetermined by this kind of history of intervention that really placed a big emphasis on psychopharmaceutical treatment, for example, over other forms of care. So, I don't know. I think throughout the book, I'm constantly trying to point out there's like both end of humanitarianism. Like it's both problematic and can be a form of violence and it can also generate new ways of caring for people and thinking about problems.
- [06:36]
A
Yeah, I felt that kind of nuance in a lot of the chapters and I felt that it was like a very human portrait of people trying to make the best of these sort of maybe limited windows of opportunity. And that kind of leads into something I was curious about in terms of maybe getting to some of the details of care itself and sort of approaches to mental health. And somewhat early in the book there's this really interesting anecdote about it's some kind of event where there's sort of a learning moment with mannequins and you're kind of manipulating these figures as a way to sort of learn about, I guess, you know, mental processes and approaches to loss. And I thought that was a really interesting anecdote and maybe you can kind of briefly describe what was happening. And one question that I had as I sort of read that story and the other stories, the many other stories in here about trying to treat mental health was I'm wondering if humanitarian organizations or counselors ever tried to kind of incorporate or integrate sort of more maybe Hindu concepts or Buddhist concepts of loss of suffering. I wonder. Yeah, I found myself wondering about the directionality and what that maybe meant in that context. Because I can imagine somebody, you know, here, like in Cambridge, where I'm living, walking into a bookstore, right, you know, in this Western context and looking for that expertise, right, like those kind of philosophies of suffering and learning about that through a psychological or spiritual or whatever self help lens. And I just found myself wondering about the flow of sort of philosophies of caregiving here. And I can imagine people being really interested in that in certain contexts. But I wonder if there was something about this context you were in where it was perhaps less present or I'm just curious how people approach that, if at all.
- [09:03]
B
Yeah, there's different ways to answer this. I mean there's different actors involved. And in Nepal, for example, so a lot of the humanitarian, many humanitarian organizations that were there doing this kind of work didn't have a pre existing relationship with Nepal and didn't really know what was going on. And there had been a lot of work done. I talk about the history of, of mental health, like community mental health in Nepal and global mental health in particular that predated this. And there was a lot of work by kind of anthropologists, global Health practitioners in trying to incorporate sort of Nepali ethnopsychology into models of care. And in the immediate aftermath of the disaster, a lot of some of these people, like, came together to create a desk report on, like, all the work on mental health in Nepal, because there's actually a huge corpus. A lot of it has come from psychological anthropology as well as global mental health, the field. So there was all this preexisting stuff, and then many humanitarian organizations didn't even know about that. And so there was this effort to try to educate. But so that's one thing. On the other hand, you had, like, on the ground, the organization that I worked with, basically foreign humanitarians would subcontract the work out to local Nepali organizations. And so this was one organization that had a long history of doing work in Nepal, like doing psychosocial work. But still there was kind of a. I don't know, like, a focus on introducing psychosocial counseling as a certain kind of way of working with emotional distress or loss. And there wasn't so much, I don't know, the kind of, like, cultural dimensions were sort of seen as, like. There's, like, the local kind of things that people do, and then we're introducing this other thing. And so I didn't see a lot of efforts to really, like, work in that way, Although I do think, like, in the US There's a lot of interest in, say, Buddhist kind of or whatever, like, meditation or things that have been inspired by aspects of, for example, Buddhism. So what I did see instead was this kind of, like, training of, for example, the Mannequin Story, a training for counselors on how to approach loss, how to face it. And this idea that was very important in the psychosocial model, that you have to talk about your grief and that talking about it will help you release it and, like, work through, you know, work through that grief. But then something that I point out is that this was actually quite just exactly the opposite of the kind of traditional ways of working with grief in Nepal, in both Hindu and Buddhist communities, where talking a lot about somebody who's died, you know, can actually strengthen attachments between the dead and the living and cause the dead to be, like, trapped in an intermediate realm between death and rebirth. And this is especially even more tricky when someone's died a bad death. And so the idea of talking in that way is almost kind of dangerous and seen as sort of taboo. But at the same time, you have, like, culturally prescribed collective forms, ways of mourning, and then you have people's personal experiences of grief that also overflow those scripts. So people struggle. And so what I heard many people say was that like, you know, I lost my child in the disaster and I can't talk about it. Nobody wants to hear about it. And if I talk about it, people tell me to stop talking about it, you know, or they, they just tell me to, they yell at me. So there's, there was a kind of policing of that. And then counseling became this space where they could talk about, they could talk about those feelings. And so again, as I think I already mentioned before, it's like in, in every chapter I try to do this, I think show the both. And it's not this straightforward story of, well, incorporating cultural ideologies of suffering and affliction into counseling is automatically the solution because sometimes cultural resources can be also violent or harmful. And so this idea that it's automatically a good is I think, not always the case. And so what I found, or what I argue is that even though counseling was introducing this very historically specific kind of western model of understanding and working with grief that we can trace all the way back to say like Freud's work of mourning and like the talking cure and the whole idea that even though it's not, it's something that's coming in from outside at the same time, it created these sort of, and I call them like, like unusual sort of shelters for expressing non normative emotions. And so I don't know, I think I try to show both, both sides that it's, it's, it's a more complicated story. And I also think personally that at its best therapy, you know, it's not just this kind of like space where new subjects are produced that might be more productive subjects. Like you could have a very paranoid reading. At the same time, I think when it's done well, it's actually, it could be a space of freedom for non normative kinds of expressions where someone's listening without judgment. And so I try to bring that kind of element out when I saw it happening.
- [14:56]
A
Yeah, that's really fascinating. It's a really helpful way to think about it that maybe goes beyond some of the more kind of simplistic maybe either or ways that it can feel very easy to try to categorize these things. As I'm wondering about a moment, it's a bit later on in the book and it's a relatively small moment, but it did capture my attention because I personally have an interest in dreams and some dream interpretation techniques. And this however, is entirely separate from anything I've ever done academically, anthropologically or ethnographically. But it is an interest of mine. And I noticed in one of your kind of descriptions of talking, you know, you're sort of accompanying these counselors out and about and. Yeah, I want to talk more about that in a bit too. It was really interesting. But yeah, I wanted to ask you if there was something about that context or maybe the relationships or something that made talking about dreams. I'm wondering, was that sort of a relatively common thing to do in your fieldwork experience? If so, how do you think about dreams as a kind of topic, an ethnographic kind of. It's something that I personally, as I read ethnographies and the literatures I tend to navigate. For whatever reason, I don't see a lot of people talking about dreams as kind of a narrative that sort of matters in some of this ethnographic work and conversations we tend to have. But I find myself really interested in how that could fit in. I mean, their dreams are so meaningful. They are quite mysterious. But I think they are really rich. And I totally understand if this is not sort of a big part of what you're doing or I know this is a fairly small moment in the book as a whole, but I did gravitate towards that. And yeah, I just wondered what your thoughts were on dreams.
- [17:19]
B
No, I love that you picked up on that. I have a lot to say about dreams. Actually. A long time ago, when I first was starting my PhD before I knew really what I was fully doing, I actually applied and did my master's project on dreams and imagination in the context of migration among Yolmo Nepali people who had migrated to Jackson Heights, Queens. And so the whole project was like looking at migration, but through dreams and daydreams and that kind of phenomenon. So I've always been interested in dreams. And there are dreams in this book. I'm thinking of a few examples. Maybe there's three. At least there's a dream I have that I know. I mean, in the beginning I think I talk about a dream, like right after the earthquake of maybe breaking my recorder. And then there's a dream of the black caterpillar that the counselor talks to me about. And then there's a dream, Rekha's dream of her daughter who died, that keeps. She has this recurrent dream. And so I attend to dreams throughout the book. Well, because I think that they are expressions of unconscious processes that are going on in the background, but that illuminate something really important about, I don't know about the experience of the disaster and different kinds of aspects of things that I'm writing about. So, like the Black Caterpillar dream that Bina, a psychosocial counselor who I worked with closely, tells me about. It wasn't like we were talking about dreams all the time, but it's more that I attend. I attend to dreams in my own. In the field work. So when people spoke about dreams, or even my own dreams, I would write them down. There's many, many dreams I had in the field that actually, sometimes I've even thought, like, it would be amazing to write a book that was only the dreams that I dreamed and then the people, and then the dreams that the people I worked with dreamed. And then what if it was this whole book of dreams that was just like an ethnography through that we're, like, dreaming each other or something like that. I don't know if it would work, but that was a dream thought that I've had in the past. But, yeah, the Black Caterpillar dream, for example, being a toxic. We've been spending the day together. I'm, like, going with her into the field, and then she says, like, oh, I had this weird dream last night of this black caterpillar. Like, it was. I don't know, it was black. And then that kind of has, like, a negative. The color is sort of a. Has a sort of ominous kind of tone for her. And she says she flung it away and she doesn't really know what it's about. And then she suggests, like, maybe she's been feeling, like, you know, worried that I might see her make mistakes or something like that. So then I thought, well, maybe I'm the Black caterpillar, and if only she could get rid of me so easily or something, you know? And that's my reading of it. And I think, like, I'm also very interested in psychoanalysis, and I think I'm kind of bringing that type of sensibility into the way that I was thinking about, like, how to interpret her dreams or just someone telling me a dream like that in the context where we were working. So that's what I could say at least a little bit about, I think. Yeah, I love that you picked up on it, though.
- [20:39]
A
I mean, that's so interesting. And it just so clearly kind of deepens maybe some, you know, the picture you have of, you know, that relationship. And, yeah, I just. I appreciate you including that. I think it's really interesting. And, yeah, maybe kind of along those lines this way in which you were accompanying people and there's this level of almost ethnography. Inevitably you're kind of scrutinizing people. And I thought it was so vivid how you kind of described how that is a little perhaps awkward for people or just there's something about this accompaniment you're doing that I wonder if you could say a bit about what it was like to kind of set yourself up and position yourself. And did those relationships kind of change over time? Did your role change? And you write so many books, sort of great descriptions and this whole chapter kind of about walking, which I really liked, and this. Yeah, maybe you can talk a bit about these long walks and the way that is sort of part of the care that the counselors were providing. But it also struck me you're also taking a really long walk as an ethnographer. And, you know, ethnography is kind of like this long walk to try to sort of leave your own space, so to speak, and go as close as you can to the other. So, yeah, I would love to hear sort of how that was maybe on a day to day level and how that might have changed over time.
- [22:39]
B
Yes. So the accompaniment of counselors, I'll start with that one. It had a lot of different meanings. I mean, there was ambivalence, like, there was the, like, I'm the black caterpillar. Like, you know, I'm. If only I could be flung away so easily. I might see some, you know, see mistakes. But at the same time, counselors also would talk to me about being like hungry for feedback because these are people who have very brief training in, you know, the idea of like task shifting, which is the term in global health and also in global mental health, is train more or less like laypeople to do very basic psychosocial interventions as a solution to the problem of a lack of infrastructure in counseling, for example. So people would get very brief trainings and then they would be sent out into the field where they would meet clients with extremely complex, challenging, painful types of problems. And they're just in it. They're in the field and they have to try to do the work and they don't have a lot of guidance. And yeah, while it might be straightforward to train a counselor in basic skills, it's not at all straightforward to sit with someone who's suffering and really like work with them. I mean, I think we don't give enough credit to the difficulty of that. Sometimes the work of the counselors even outstripped their supervisors who were back in Kathmandu, who actually, I mean, that's a Whole other issue, but, like, who may not have even been working with cases that were that complicated. So, which is to say that counselors also wanted feedback and would tell me, you know, that, like, we would talk about what they were doing, and it seemed that that was supportive for them. And I think so. There was this kind of, you know, both I could, like, are they making a mistake? But at the same time, like this, my presence could also be seen and was experienced sometimes as being supportive and, like, you know, giving them feedback. And also, part of my role was to. Was to support counselors, and I would try to communicate their concerns back to the supervisors and foreign project manager in Kathmandu. And I was sort of like a liaison in that way between these different levels of work in the organization, which is very hierarchical. And so counselors then started to see me as someone that they could tell their concerns to and that I would be able to communicate that in a way that people would listen. And. And then also, just like the walking, which I remember, like, this moment, and I think I read about it too, where doing this, I was like, well, when, like, all we're spending all this time walking, like, what about the actual counseling itself? It seemed like 90% of the time was spent actually just getting to the people. And then I started realizing, well, that's also part of it. That's also a huge part of the work, and nobody talks about that. And so maybe I have to just write about walking, which seemed really weird at first, but it just stuck with me as something that was there. I had to talk about it. And so through walking with counselors across in the disaster zone, and also sometimes walking 8 or 10 hours to reach somebody to try to meet with them, that also brought me closer to the counselors in which I was, you know, walking alongside them doing this work that was difficult. And I think that was also unusual, like, staying in the same places where they stayed. And I think that also kind of created a bond between me and the people that I worked with. And you were saying, like, it's interesting to think of ethnography as a long walk. And I was, you know, I don't know. I was inspired by, like, Tim Ingold has a piece on walking, like, as a method in ethnography. And I was really struck by that. And although we can also say, and I point out that walking with someone is not going to give you access to their experience of walking through the terrain, it's not like an automatic equivalency, you know, between my experience of walking and the people I'M walking with. But we did share a horizon in which we were walking towards suffering and towards people together. And that kind of embodied methodology, which I didn't do purposefully, but which was just. It just happened, but it really shaped the work in a lot of ways.
- [27:15]
A
Yeah, yeah. I think it was really great to bring that into the frame. I mean, for me at least, I never would have thought about it or even guessed it, you know, that the terrain and the time and the physicality of it is so. So front and center. And it really just contextualizes it so much more than maybe these more technical kind of ways of accounting can capture. And I guess on that note, I have one last question around ethnography as well. And I guess I'm wondering about the place of ethnographic research in the global health world, sort of broadly speaking, but also maybe in your case, I wondered if you have this chapter on efficacy and effectiveness and how data drives mental health interventions and disaster responses and these sort of modes of accountability and capturing effectiveness. And I kind of find myself wondering. I mean, I think it's not surprising that you have to sort of generate data to funders and so on. And I guess I was curious if you felt that you were ever called upon, sort of in your capacity as an ethnographer to like, do you think there was a kind of ethnographic or even just semi ethnographic data collection role that was sort of legible to some of these organizations? Does that make sense? Is that kind of data part of how people were interested in measuring effectiveness?
- [29:05]
B
I can't really speak for global health as a whole. I could speak for the organizations that I was connected with in this project. I think it's different in different fields. Um, I was somehow lucky that I met this foreign development worker who was the project manager of this. Of this intervention, who invited me to be the ethnographic consultant and who had a kind of understanding of anthropology and wanted like, thick description, you know, like quote, kind of like had a Geert at least knew who Geertz was and valued ethnography. And that was, I think, very rare, but something that happened. And so it was really like. I think their motivation was they wanted to know, and ultimately, are the things that they're training the counselors in, are they actually doing those things or what are they doing in the field and what's working? And if they're doing something that they're not being trained in and it's like a kind of their own creation, like, what is that thing? Because ultimately they Want to figure out what works. And so maybe an ethnographic eye could capture that. And that was, like, the context of my use in a way. And that was. But beyond that, I mean, I don't know. My sense is that it's kind of rare. My sense is that the relationship I also had with the NGO is somewhat rare too, in that it was just a very. Like, we would use my data. We would have these meetings where I would be, like, in the meetings with the supervisors and Kammandu and the. And the staff, like, running the ngo. And I would talk about, like, scenes that I talk about in the book. And they would be, like, difficult conversations, you know, but. But they wanted to have them. And sometimes I would be critical and.
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A
Okay, so they were difficult in terms of, like, maybe there was a disagreement or.
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B
Well, yeah, like, if I point out, you know, like, I don't know if I, like, describe a scenario and talk about, like, a difficult aspect that might be coming up. I'm trying to think of an example, like, oh, if a client is talking about how they're treating, medicating themselves with alcohol, and the counselor is raising her eyebrow, saying, oh, really? So what do we. Then? That's a kind of judgment that is being. I mean, it was like, at that level of detail, like, thinking about, you know, and so. But then. But there were. They were. There was a kind of openness to talk about that. And I think that that's really. I don't know. I feel like that was rare. And I really. I'm so. I feel so lucky that I got the chance to work with a group that was, like, open to having an anthropologist in their midst and talking about the kinds of things that. That I was finding and not, you know, there wasn't. I don't know, it was just. I think that's unusual. And even from the beginning, like, being invited just on the basis that ethnography is valuable. But I don't think it wasn't used to get further funding for them or anything like that in that way. But it wasn't directly used as evidence or anything like that. But it was more used along the way to support counselors and to help train counselors. Yeah.
- [32:33]
A
Yeah, that's interesting. It's a cool. It sounds like a good synergy happened. Well, you've taken a lot of your time, so thank you. And there's so much we didn't get to talk about that's in the book. So, you know, to those listening, do read the book to read all the things we don't have time to dig in deep about. But before we end this, I do want to ask you, do you have anything you're working on right now, looking ahead?
- [33:04]
B
Yeah, I do actually. So since I finished this book, I've been working on a new project on psychedelic medicine in the US So I have this project called Ethical Psychedelic Medicine in Times of Social and Spiritual Crisis. And I'm kind of like pretty far along in it already now. And it's very different from my work in Nepal, but at the same time has a lot of connections. And so I could just say briefly, in Nepal, what I was following was the expansion of psychiatry and counseling into a region that has a long tradition of shamanic healing and spiritual healing for psychic afflictions. And then there was this introduction of this new therapeutic modality. Whereas in the US What I see is the kind of. Well, I should also say. And the introduction of the new therapeutic modality in Nepal is based on a traditional form of psychiatry and counseling in the U.S. what I see is a kind of rejection of increasingly or a dissatisfaction of traditional psychiatry, a kind of awareness that there haven't been innovations in a long time, a desire for a different kind of treatment and an interest in psychedelics that often bring with them shamanic lineage. I mean, that are part of shamanic kind of lineages. And so I sort of see the two projects as kind of like the Janus face of each other or something. So while I was looking at the expansion of this traditional modality into Nepal in the US I see a rejection of that and interest in almost finding some kind of treatment that I don't know that involves plant spirits or that involves revelation and involves. Anyway, so that's. So I'm looking at, I'm doing this current project and it's multi sided with. Yeah. In a psychedelic therapy training program in a clinical trial for psilocybin to treat demoralization at the end of life in underground psychedelic churches and with ketamine prescribers and patients. And so that is the new project that I'm working on now. And it's.
- [35:15]
A
Yeah, yeah, that's absolutely fascinating. I'm excited to see how it all comes together. And yeah, I love the symmetry of these projects kind of following each other. Yeah, that's really fascinating to trace. Well, thank you so much for talking today. And yes, the book is the work of crisis and care along a Himalayan fault line. And it's out from the University of Chicago Press. Thanks so much, Sam.