Thursday, August 13, 2009

Making Headway...

For all the frustration at the state of paralysis from which my research seemed to suffer in the past months, it has been unexpectedly easy to jump-start my project.

After deciding to pursue interviews with mental healthcare practitioners around town, I spent a day collecting names, phone numbers, and email addresses. I made myself an Excel spreadsheet, then bit the bullet and started making phone calls.

Of the five psychiatrists I called over the course of an hour, two actually picked up the phone, and both agreed to a meeting. These meetings, both very brief, each produced an hour-long follow-up appointment for an interview. One takes place tonight, and one next week.

These two scheduled entretiens are an addition to the interview I conducted last night, with the prominent psychoanalyst I met with two weeks ago. I have thus gone from nothing to three interviews within the course of a week, and in the process have proven to myself that all of this, this research, may actually be doable.

What I have noticed so far, over the course of my brief meetings with three different psychiatrists, is the diversity that characterizes psychiatric practice(s) here in Rabat – and this alone proves that pursuing these interviews was a good idea; that limiting myself to the psychiatric practice of the Clinic would have produced a skewed, one-sided picture of reality. Every time I mentioned to the psychiatrist I was meeting with that I was interested in interviewing them as a way of broadening my understanding of psychiatric practice in Morocco, I received an instant nod in agreement. Good idea, they’d say: there’s such a variety in approaches and philosophies here, that it’s important to expand your scope. Interestingly, they all characterized practice at the Clinic as ‘Americanized’: as very ‘biomedical’ in its approach. Despite the fact that they all seemed to strongly approve my choice to conduct research there, I got the sense that this characterization was not necessarily positive; the tone implied limitation. It makes me curious to know more about how these independently practicing psychiatrists characterize their own brand of mental healthcare (and whether they will associate this with a particular region of the world, as well).

In general, I’m curious to know how this emphasized variation in practices will be reflected in the interview data I gather over the course of my conversations with these psychiatrists. But a curious diversity that has struck me so far, in visiting these three practices, is a considerable variation in the material wealth expressed by the office décor. Whereas the prominent psychoanalyst with the downtown office is housed in bright, breezy, sleek and chic quarters, the doctor I spoke with yesterday, for instance, sees patients in an old, dilapidated apartment building in my own neighborhood. His walls are bare; his furniture is old, plastic, and mismatched. Despite French doors that open out to a balcony, the air was hot and stuffy. I wonder what this variation is suggestive of. I see it as a reflection, if anything, of psychiatry’s under-funding by the state. This kind of variation in wealth is possible, I think, only because these psychiatrists receive nothing from the government, and are dependent on their own wealth and income. Is the state of their office then a measure of their success as a psychiatrist? Or, if (as the prominent downtown psychoanalyst suggests) psychiatrists receive patients from all walks of life and charge them on a sliding scale according to means, is it indicative of the kinds of patients they receive?

What all three practitioners had in common, though, was a great friendliness and hospitality toward me. My initial meetings with them were brief, but all expressed an interest in reading my proposal, and agreed to schedule more time for an actual interview. If this is characteristic of all mental healthcare professionals in Rabat, doors may be flying open a lot more easily than I had anticipated…

Last night, then, I conducted my actual first real interview, with the prominent downtown psychoanalyst. We met in his psychoanalytic office, a room I hadn’t seen before. The two meetings I had had with him had been conducted in his ‘office’ – a white-and-gray room dominated by a huge desk. He had sat on one end and I had sat on the other, and it had made me wonder how he was able to conduct psychoanalysis there. This question only deepened as I visited the other practices, which – despite simpler décor – did feature actual Freudian divans. I had just begun to wonder if, perhaps, the prominent psychoanalyst’s practice was larger than I had initially thought when, indeed, I was ushered through a door I hadn’t noticed before and let into a large but intimate room, featuring the requisite psychoanalytic couch.

I didn’t come close to finishing the list of questions I had brought with me, but obtained a wealth of information (that I will process and perhaps write about here, once I have listened to the recording again). As I had noticed during our first meeting, prominent downtown psychoanalyst likes to talk. He is, and very much sees himself as, a pioneer and rare expert on the practice of psychoanalysis in Morocco. He has distinct theories about how cultural specificities relate to universal psychic processes, writes countless books about issues in ‘cross-cultural psychology’, and took a lot of my questions as diving boards into a presentation of his arguments on this topic. After the interview, I noted down in my field notes that he had been in an explanatory or demonstrative mood, rather than a reflective one. He had an agenda in speaking with me, he wanted to convey a message to me. I wonder if he will ever make the transition to more reflectiveness if I continue to speak with him – but whichever state he was in, I learned a lot. I asked more questions this time around, directed the conversation a bit more, but also left him to take my questions in whatever direction his free association took him; I wanted to know what my questions made him think of.

I’m still curious to see him psychoanalyze someone. As someone so eager to talk, I have a difficult time imagining him as a quiet listener. Seeing him in his actual psychoanalytic office last night made the image a bit more tangible, but even there, and despite his immediate framing of this meeting as my turn to direct the conversation (“je vous écoute”, he told me as soon as we sat down), he was the dominant conversation partner.

I left the psychoanalyst’s office on an absolute high, last night. I felt as though I had crossed a crucial hurdle. I had taken the first step, and it would all be easier from that point on. Nevertheless, I’m nervous for my second interview, tonight at 6. In theory I am excited about the process, about these new opportunities, about the fact that I am finally engaging in actual researcher-activities. But emotionally, I’m not quite caught up with that excitement yet. I still feel nerves. I still tend to look up at the precipice of the mountain that is my research and, realizing I am still at the bottom, feel a bit of vertigo.

I’m guessing it will take a bit of time to get over the initial nerves and gain a bit of confidence in my abilities as a researcher, and as a French-speaker. But I’ll get the hang of it. The important thing to focus on is that I’ve (finally) gotten started. And that, despite the daunting presence of the mountain ahead of me, I’m putting one foot in front of the other and making slow progress…

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