Difficult Questions

A few months ago, I saw an Italian movie entitled Vincere. It tells the story of a woman who falls in love with a young Mussolini, marries him, and bears his first child. He then disappears from her life, and while he grows increasingly influential in Italy, she continues to pursue him and demand that he acknowledge and care for his son. Mussolini never responds to her demands and eventually she is thrown into a psychiatric hospital, where she is told that she is delusional and paranoid. Her claims are, in other words, forcefully rendered null and void by the silencing blanket of a psychiatric diagnosis.

The film ultimately never tells you whom to believe. The story is told from the woman’s point of view; the love story is thus as real to you as it is to her – and the psychiatric diagnosis as much of a shock. Then again, the movie reminds you that no documented evidence of the purported marriage, nor of the son’s paternity, has ever been found – and that the woman ultimately had nothing but (irrational?) persistence to fall back on.

The way I see it, this movie brings up an uncomfortable but undeniable issue inherent in the practice of psychiatry: to what extent do psychiatric patients retain the right to a voice, and a claim to truth? Does being mentally ill really mean that one is no longer capable of rationality or logical thought, and does that thereby authorize the rest of us to stop listening to such a person’s voice, and to make decisions on their behalf?

This question has come up a lot for me over the course of my fieldwork at the Clinic – I think of Marwa’s outrageous stories, for example, or Nadia’s and Mr. Abbas’ linguistic (and other) claims to some modicum of status. I think also of other patients who lament that no one at the hospital listens to their complaints, or others who have been abandoned by their families, conveniently left behind and out of sight in the safe confines of a psychiatric clinic. I could write endless stories about the impact of psychiatry on the experience of agency and autonomy among the women I’ve met. And I probably will.

But the reason I bring up this issue now, is that it has recently been thrown into particular relief – in the sense that I seem to have gotten myself quite actively involved in a case where the question of ‘agency’ lies at the very heart of the doctors’ difficulty in devising an adequate “prise en charge.”

A few weeks ago, a European woman was hospitalized at the Clinic’s closed ward. She had been wandering around Morocco for a few days when she was picked up by the police for attempting to trespass on Palace grounds, and brought to the psychiatric emergency department. Because this woman speaks no French and the doctors speak very little English, I was asked to help facilitate the communication by doing a bit of translation. One conversation led to the next, and slowly but surely, I slid right into the middle of it all, becoming a bit of a mediator between doctors, patient, her country’s embassy, and her insurance company.*

The hospitalized woman believes herself to be a medium of sorts. Her supernatural powers have granted her visions, most of which revolve around vast conspiracy theories – some of them involving herself as the target. She is convinced, for example, that the entire global network of her country’s embassies have joined forces with the Moroccan police and the Clinic, all in an effort to silence and imprison her. As you might imagine, this does not exactly leave her willing to listen to anything the doctors (or the embassy) have to say.

The Clinic, understandably uncomfortable with this very foreign patient, would have preferred for the embassy to take her off their hands. They had hoped or assumed that a few phone calls would mobilize this European country’s network of diplomatic and financial resources, and that with a day or two some representative would come to repatriate the delusional wanderer.

The embassy, however, had a very different point of view. The patient had aggressively refused their initial attempts at communication, and to them, this effectively annulled any and all obligations they may have had toward this woman. As they explained to me, the ministry of foreign affairs would not be authorized to do a single thing, unless the woman herself indicated a wish to be assisted.

A group of doctors attempted explanation: a psychiatric patient cannot be taken at her word, they told the embassy’s representatives. This woman’s judgment has been impaired, and her rejection of help should thus in no way be taken seriously. At times like these, decisions have to be made by experts who know what’s best for her. But the embassy stood firm, and politely apologized: the patient was now the responsibility of the hospital and the Moroccan police; they were free to decide as they wished.

This is the stalemate in which we now find ourselves. The hospital feels that it cannot, in good conscience, release this woman back to the streets (not in the least because she herself indicates that she intends to go right back to the Palace and try to gain entry. Which means that most likely she’d just be picked up by the police again, who for all we know might take her to jail next time). However, keeping her at the Clinic clearly is no more of an ideal solution. Without the possibility of actual conversation between patient and doctor, effective treatment becomes nearly impossible, and the stalemate continues.

So what is the answer here? Should the woman’s refusal of help have indeed been ignored, under the presumption that she is in no condition to make decisions on her own behalf? Should the embassy have stepped in? Or were they right in respecting the woman’s voice?

I have to admit that I’m undecided. Theoretically, I would and always will argue that no one should ever be deprived of a voice. Everyone, including someone with a psychiatric diagnosis, has the right to be listened to. Everyone has the right to their own personal version of truth, and behind every delusion lies a subjective lived experience in need of some kind of resonance, even if simply with a sympathetic ear. In addition, dangerous power issues lurk in the shadows of cases like these. There is a dark side to the history of psychiatry; there have been instances in the past (distant and not-so-distant) where it has been used as a convenient way to silence individuals with viewpoints that were dangerous for the stability of the status quo (which is, in fact, exactly what this particular European patient is accusing ‘us’ of doing).

Besides – who are we to decide what’s ‘rational’, ‘true’, or ‘valid’, anyway? What makes a psychiatrist the expert? Aren’t all these concepts ultimately relative?

But this time I’m compelled to think and reflect from a vantage point that is no longer merely theoretical, and it’s led me to think more about the other side of the coin – it’s let me perhaps to better recognize the very real and very thorny complexity of the whole issue. I will always maintain that the above theoretical questions are important to keep in mind, but the very practical scenario that we are dealing with at the moment raises an additional, very different set of concerns; concerns that have not so much to do with the existential right to agency as they do with the real-world consequences of allowing a delusional person to make their own decisions.

Yes, a patient should always be listened to, heard, validated. But if the patient’s only request is to be released from what she sees as inhuman imprisonment, and you know that, were she to be sent back out to the streets she would most likely be picked right back up by the police and brought back to the hospital (or worse, jail), what do you do?

And if a patient refuses to take her medication, claiming that she is not sick – but your medical training tells you that pharmaceuticals are the only quick and effective way to help her find her way out of hallucination, are you justified in forcing it on her?

And finally, where do you draw the line? When Marwa told me about military bases on other planets, I was fairly certain that this truth existed only in her mind. But when a woman claims to have given birth to Mussolini’s oldest son, whom do you believe, and on what basis do you make that choice? How far do you go in finding ‘proof’? Who, in the end, has the right to determine whether or not a mind is ‘rational’ enough to retain its claims to agency?

* This is a new role for me at the hospital. I’ve always been the observer, never the participant. I’m not a psychiatrist, not a psychologist, not even a social worker; I wasn’t qualified or able to really do anything useful. Now, suddenly, I’m being involved, asked for input, even needed perhaps – and I have to admit that it feels really, really good. I love the idea of being able to do something.)

Beating the Odds?

I’m writing a second piece on the same patient, for a change – because Soukaina’s story isn’t finished. In the weeks since I posted my initial description of her, she has truly and amazingly come alive. She has cast off her shadows, and seems to have beaten the depressing psychiatric odds with which I ended that first post.

It began with laughter. A kind of bubbling energy she simply could not keep inside. An entire Thursday morning meeting once played itself out to the underlying soundtrack of Soukaina’s bursts of hilarity. Like a steady rhythm, she accompanied other patients’ words, sighs, and tears with her own uncontrollable snorts, giggles, and whinnies. The same impulse would get the better of her when out and about on the ward; the tiniest odd sound could set her off. She tried to hold it in, she really did – hands shielding her mouth like a prison door, the head pressed tightly into her knees, she did her best to maintain an internal sense of order. But to no avail; she seemed beset by an effervescence too large for her small frame.

Her laughter then paved the way for words. Cautious utterances at first: a tentative “mezyane” (good) or “nglis?” (can I sit?). But with every passing day, her voice grew stronger and her communicative overtures bolder. And last week, this development culminated in an actual conversation. She and I sat side by side on a bench in the sun, my hand in hers, as she asked me question after question. Where was I from? Where were my parents? Did I have brothers and sisters? Where did I live now? Did I live alone? What was my job at the hospital? How old was I?

This conversation likewise had its own laugh track. Everything I said prompted a burst of giggles. Maybe, I remember thinking self-consciously, it’s my horrible pronunciation of Arabic. Maybe it’s my strange blonde hair, or the way I look at her. But maybe it’s simply her own joy at the lifting of that mental cloud – and maybe it’s all of those things at once.

But mostly, I remember, I simply had the urge to giggle along with her. I responded to each of her questions with one of my own, and I reveled – as she sat there with her eyes full of recognition; as she revealed her self to me. I reveled in the possibility of being able to actually listen to her.

There was an urgency to it all. We talked as though we were making up for lost time – or perhaps as though we were afraid this window might close up just as quickly as it had opened. But the next morning, when I found her again in the courtyard, our conversation simply continued.

This time she requested to see photographs of my family. I took her with me to the doctor’s office, opened up my laptop, and showed her a collection of pictures. Again, her reaction was strong and fizzy. It was the details that seemed to strike her most – the color of my sister’s dress, my father’s glasses, a can of coke in the background somewhere. It all met with an explosion of laughter, and constant, repetitive requests for me to explain what was shown in the picture.

After lunch on that same day, it was she who dragged me back to the doctor’s office. I once again opened up the pictures of my family – but that’s not what she wanted, this time.

“Show me pictures of the king of America,” she now demanded.

I smiled, toyed briefly with the idea of interpreting that creatively, then connected to the internet and searched for a few pictures of Barack Obama.

Soukaina showed a decided preference for a set of photos depicting the president along with his family. Old wedding pictures, or professional portraits of the Obamas with their kids. Again Soukaina responded with laughter, and endless requests for me to identify each individual in the frame.

Her favorite photo of all showed Obama’s two young daughters, gleaming on a stage somewhere – a snapshot moment during the campaign trail, no doubt. Soukaina stared at it for a while, as though caught by something; then pointed to Malia’s dress and looked me in the eyes.

“what do you call that color in French?”

“Rose,” I responded. “Like your pajamas.”

Soukaina looked down at her own chest, looked back up at the picture, then turned to me.

“Rose,” she repeated, and once more burst into laughter. She leaned in, hugged me close, then kissed me on the cheek. I couldn’t help but laugh with her. I was mystified by the connection she had just somehow made, the recognition she had found in that picture of two unknown girls –

… but I loved it.

And I hope with all hope that she holds on to this clarity and joy…

An impossible Choice

Wherever the action is, there you’ll find Soukaina. She spends her days strolling along the ward’s courtyard, observing life as it is lived by her fellow patients. Not yet 15 years old, she is always dressed in the same stained pair of pajamas; her feet drag along a pair of pink plastic slippers, and her hair is haphazardly covered by a disheveled headscarf. She makes her rounds at a steady pace, arms swaying heavily by her side, shyly looking around at her passers-by. She halts in the occasional doorway, quietly watching as other women are having coffee with their visitors. Then she moves on to investigate what’s going on at the end of the hallway there, where her doctor is conversing with an anonymous face. She makes a u-turn, stopping briefly to poke her head inside the nurses’ office, then fixes her attention on what the gardeners are doing to the bed of roses in the courtyard. She finally ends her tour by settling down beside the group of women seated on a bench, basking in the morning sun.

Soukaina always maintains a bit of distance. She does not like to be touched; any well-intentioned attempt to shake her hand, or make an offering of candy, invites a subtle dance of evasive shifts and shakes of the head. Soukaina has a voice, but prefers to parcel out her words in great moderation; any verbal overture is shyly answered with a quick and tiny smile. At every Thursday morning ijtima’, Soukaina’s doctor performs the ritual of trying to coax out a phrase or two. “Kif bqiti?” she’ll ask, her voice sweet as honey – how have you been? Each week, these questions hang suspended in the air, lonely and heavy with awkwardness, until a few other patients decide to speak up on Soukaina’s behalf. “Oh, the other day she was so chatty!” they’ll say. “Soukaina loves to talk with me, we were laughing and crying together all afternoon!”

***

Soukaina has been on the ward for as long as I can remember. She was there when I first arrived in November and has been a stable presence ever since, quietly strolling through the corridor as other patients come and go around her – like a fixed point of light within a changing image. Over the course of these long months she and I have made slow but steady progress in the buildup of a communicative routine. By January she began to return my greetings with a smile; by February she developed the habit of sitting down beside me as I wrote up my notes, occasionally stretching out a cautious but pioneering finger to get a physical impression of my notebook. By March she began to ask me for the time – always a rapid whisper, barely audible, but words nonetheless! – and by April, she took to following me as I made my own rounds across the ward.

It was around this time that Soukaina was briefly discharged. Her absence did not last long, however; she had spent not four weeks at home with her family before she returned to the hospital and once again took up residence in her old room, as though nothing had ever changed.

Yet something had changed.

I had always thought of Soukaina as an empty notebook; as a set of pages without a story. Beyond the smiles, her eyes were blank – an infinite whiteness that led me to see Soukaina as a moving body without emotions, a conscious mind without thoughts.

This new, re-hospitalized Soukaina remained mute, but now the light seemed to have been turned on behind her eyes. The blankness of before had made way for images, for bright colors in broad brush strokes. I saw an abstract painting, now; a palimpsest of stories each racing out to envelop the beholder.

For a few days, the entire ward reveled in what we thought of as a very pleasant change in Soukaina. Her smiles had become broader, her voice more solid, and her eye-contact more eager. Real communication had begun to seem like a possibility.

Then, from one day to the next, the smiles disappeared. I arrived on the ward one Monday morning to find her sobbing in the courtyard. She saw me as I entered, ran over, and grabbed my hands. For the next three hours, she refused to let go. She dragged me along as she walked restlessly through the corridors, drawn mostly toward the exits – as though she was waiting for someone, or something. The stories in her eyes had become jarring, glaring, frightening in their blackness.

Apparently it had been this way all weekend. “Meskina,” the nurses sighed. “The poor thing – she’s suffering from horrible anxieties and hallucinations.” Whatever had turned on the light behind Soukaina’s eyes had also unleashed something sinister – a monster seemed to have emerged from the shadowy recesses of her mind and now haunted her without reprieve.

Whatever it was, it had exhausted Soukaina’s small body; whenever I managed to sit her down for a moment, her head would begin to loll with the heaviness of sleep, her entire body heaving in yawns of primordial force. Yet she refused to lie down in her bed for a nap, no matter how sweetly our coaxing – and how potent the sleeping pill she’d been made to swallow. It seemed that circling around the ward was Soukaina’s only source of comfort at the moment.

As she pulled me along, I tried to ask her what the matter was. “Yak la bas?” What’s wrong? And Soukaina would simply look at me, a heart-wrenching urgency in her eyes. Her mouth would move, but the sounds remained stuck in her throat. Breathing heavily with the weight of anxiety, she simply pulled me closer, grabbing my forearms now, as the tears ran down her cheeks.

***

Soukaina has schizophrenia, but the autism she was born with has pushed the mute button on her suffering. She is haunted by terrifying delusions and hallucinations that she is unable to communicate to the outside world; she is imprisoned in the tower of her own mind, with a monster in her cell.

Soukaina had always been on Clozapine, a relatively old anti-psychotic drug usually prescribed only as a last resort for those who don’t respond to anything else – because while highly effective, Clozapine comes with a high risk of potentially life-threatening side effects. The drug had pulled a heavy blanket of sedation over what little communicative ability Soukaina had had. But at least, her doctor reminisces, it had gotten rid of the hallucinations - and it had left her calm, content, “gérable."

Soukaina’s parents, however, had not been satisfied. They remembered Soukaina as she had been before illness laid claim to her mind – peculiar, yes, but nevertheless talkative, receptive, capable even of going to school. Hoping for a better outcome, her parents had convinced Soukaina’s doctor to re-hospitalize her and try a new approach to treatment.

“But do you see what happens when you mess with something that works?” The doctor sighs. “All we’ve managed to do is de-stabilize the patient.” Hopefully, she adds, the parents will now realize that Clozapine really wasn’t all that bad.

***

What I find saddest of all about Soukaina’s story is that the doctor has a point. While it may be tempting – worthwhile, even – to dream of perfect cures, there are times or cases in which the reality of psychiatric treatment forces one into an impossible choice between two very imperfect options. While listening to the doctor talk, I had the urge to protest. Could “calm and manageable” ever be a desirable outcome for anyone, given the beauty and creativity that the human brain is capable of producing? Is it ever acceptable to accord someone a fate of diminished mental capacity, if the trade-off is a reprieve from psychiatric symptoms?

It isn’t. Yet I realize that this is not what the doctor is arguing for. She does not see “gérable” as the ideal end-result of Soukaina’s treatment. Not in the least. But in her capacity as a psychiatrist, she is nevertheless compelled to play the role of the realist. And the heart-wrenching reality of this situation quite simply is that Soukaina has to choose between freedom from hallucinations, and freedom of communication.

Freedom of Expression

It is Thursday morning, and the patients and doctors of the open women’s ward are gathering in the lounge for the weekly ijtima‘ – an hour or so of sharing stories, experiences, and impressions of life at the hospital. As the women take their seats on the couches – traditional design, but with a modern twist – the hum of excited whispers hangs in the air. There’s been conflict in the corridors this week, and the patients are expecting the issue to come to a head at today’s meeting.

This morning I sit next to Nadia, a woman in her fifties who has been hospitalized for treatment of depression. She’s been here for a few weeks now, and is clearly doing better. She no longer isolates herself in her room, and she’s become more talkative of late. She’s gotten back into the habit of applying eye make-up in the morning, and the curl has returned to her short, auburn hair.

She is slightly restless this morning as she listens to her fellow patients’ stories. The group’s anticipation has been satisfied; the two women engaged in conflict have indeed brought their issue to the meeting. It’s a dispute over religious freedom: whereas one party claims her right to religious expression (in her case, the vocal recitation of Qur’anic verses in the ward’s corridors), the other argues for her right of protection from religious indoctrination (especially at ten o’clock at night, when she would prefer to be sleeping). With building emotion, the two women explain their viewpoints to the group; the doctors are barely able to maintain a sense of order.

It is a heavy topic for any group of Moroccan women to stomach on a given Thursday morning. Yet it’s not the content, but the form of the argument that prompts Nadia to lean in and whisper a question in my ear.

“Can you follow all this Arabic?”

I smile, make a gesture with my head to imply that I’m getting the gist, and suggest we try to listen. But Nadia isn’t done yet. She leans over again, seeking understanding in my eyes.

“I have a really hard time understanding Arabic,” she confesses. “I’m not used to it at all.”

And indeed; when it’s Nadia’s turn to talk, she makes a point of announcing that she’d rather speak French. She cannot express herself as freely in Arabic, she explains to the doctor – whose nod of the head indulges Nadia in her request. And so Nadia begins, noticeably changing the tone of the meeting as she informs her audience, in that soft lyrical French of hers, that she had a good week. A few women shift in their seats, straightening their spines, and a subtle sense of formality seems to have impregnated the air around us. All disruptions have come to an end; even the bickering party is now silently listening. And then – just like that, in a blink of an eye that completely negates the gravity of her original request, Nadia downshifts back into Arabic, formulating her closing statements in the local dialect.

***

Nadia identifies herself as Moroccan, and as a Muslim; she says she is proud of her cultural heritage and of her family’s illustrious history. Nevertheless, her words and behavior always betray an apparent need to separate, to distance herself, from mainstream Moroccan consciousness. Contradiction and juxtaposition weave themselves continuously in and out of her autobiography; they are the backbone to her stories’ continuity. She was born to a conservative family and raised in Fes, that bastion of tradition – but she was educated at the French mission’s schools, and walked around her neighborhood’s streets in pigtails and short skirts. Her siblings all followed in her father’s footsteps by pursuing degrees in theology – but Nadia chose instead for a career in medicine. Arabic is the language of her country and her family – but Nadia prefers French, the language of international sophistication. And finally, her sisters have all been unhappily married for upwards of 25 years – while Nadia is a divorcée who’s had several long-term boyfriends.

The status of being divorced exerts a major gravitational pull on her narrative of juxtaposition. It is the dominant cause of her sense of difference; all other facets of her identity revolve around the epicenter of its force, twisted and bent in their own path of expression. Nadia tells me several times that divorced women are “très mal vues” in Morocco; on the scale of status, they rank lower yet than donkeys. She feels that other women – her doctor included – are both unable and unwilling to understand her lifestyle of sexual independence. Utterly incapable of imagining how that kind of freedom might taste, these women cower away in fear of transgressing such moral boundaries themselves. As we sit in the ward’s courtyard, Nadia points to a handful of other patients walking around: these individuals refuse to talk to her, she says; they treat her like a leper. “They must have been married as virgins,” she concludes with a sigh.

Men are not much more capable of comprehension, Nadia laments during our next conversation; sadly, she does not derive much fulfillment from the “amis” she’s had. Moroccan men do not understand her needs. However enlightened or “moderne” they may have claimed to be, her boyfriends nevertheless all expected to be wined and dined – “by me, a doctor, for goodness’ sake!” Nadia exclaims in lingering outrage – without providing much in the way of commitment in return.

To Nadia, Moroccan culture is the source of her illness. Her depression was born of suffocation; a case of asphyxiation by the insurmountable baric pressure of cultural mores and taboos. She spent a few years in France, and remembers it as a place of lightness and air, without a care in the world to weigh her down. The thick, winter blanket of sadness did not descend upon her until she returned to her native land, 15 years ago. I thus begin to wonder if her preference for speaking French might simply be driven by the need to breathe. Perhaps that speaking Arabic – a language indelibly linked to and thus bound by Moroccan standards of (expressive) propriety – feels to her like breathing air deprived of oxygen. Might French then be her escape hatch, a seam in the tightly spun fabric of moral codes? A helium balloon that lifts her high beyond the reach of Moroccan gender expectations?

Regardless of her feelings about Arabic, however, Nadia also speaks French, quite simply, because that is how she was trained. After an education at Morocco’s French schools, a medical degree, and a life lived in Morocco’s elite social circles, it is no surprise that Nadia is more easily able to express herself in French than Arabic.

To her, in any case, this linguistic preference in no way precludes her identification as a Moroccan woman. Though Nadia may take issue with what she sees as certain outdated standards of propriety, she eagerly joins in on conversations about local cuisine, asserts herself as an expert on traditional wedding attire, and confidently proclaims that, even if she does agree that Qur’anic recitation should be reserved for the privacy of one’s room, she believes in the Holy Book’s absolute truth. Nadia’s Moroccanness may be a little particular, a pick-and-choose sampling of the full available menu – but it is nevertheless genuine.

To other patients, however, Nadia’s frenchness signals a pollution – a threat, even, to the authenticity of the ward’s Moroccan identity. And like Marwa before her, she elicits the occasional hostile reaction.

In one such case, the hostility came from Halima, a fellow patient who happened to overhear Nadia in conversation with the parents of a newly admitted young woman. Nadia had eagerly asked the French mother of this young patient where she was from, and then began to share her own pleasant memories of time spent in that particular city. Halima had been standing nearby, and now approached to hiss at Nadia, in French:

“Stop bothering these people, they’re here for their daughter; they don’t want to talk to you!”

Nadia looked at her calmly. “I’m just trying to be friendly, Halima,” she explained. “I just want to make them feel welcome.”

The couple in question listened in slightly disconcerted silence as the two women continued their argument over their heads. Halima had retorted that this couple had no need for a welcoming committee; they’d been living in Morocco for years now. Upon which Nadia had responded that it is always nice to exchange memories of other places, and to hear about familiar cities in France.

Halima, at a loss for a witty retort, responded with an angry look and then grumbled, in the local dialect: “well, I’m Moroccan, and I’m Muslim. I’m proud of it, and I’m going to speak Arabic.”

“But that would be impolite,” Nadia responded in French, calm as ever.

“Not at all,” Halima corrected, still in the local tongue. “These people live in Morocco; they understand Arabic perfectly.” And with that, she walked away.

Nadia turned to the couple, and offered them an apologetic smile. Then she looked at me.

“Do you see these Moroccan women?” she asked. “They’re so short sighted, they don’t understand any lifestyle that doesn’t resemble their own.”

Back in the Day...

Over the past few months I’ve been working on an essay to submit as part of a proposal for an edited book about the experience of doing research in Morocco. I’m using some ethnographic anecdotes from my work at the Clinic to illustrate how the complexity of Moroccan society’s multilingualism plays out in daily life, and what it all means for someone trying to do research in such a setting.

What follows below is an excerpt from my first draft. After taking a second look at the essay I’ve realized that this section doesn’t quite fit with the rest of the piece. The excerpt describes an episode from one of my very first months in Morocco, and more than a year and a half later, my experiences and circumstances have changed so vastly that this particular little story no longer seems quite relevant to the message I am trying to convey. Yet I cannot bear to simply throw it away. Because relevant or not, this anecdote has become a pleasant memory – and it is a reminder, in many ways, of how far I’ve come (and how much I’ve learned) over the past 20 months.

And so here it is, in blogpost-form

In the fall of 2008, I arrived in Rabat, Morocco, for a period of preliminary fieldwork for my dissertation research. Through a language school in the city’s old medina I arranged for three months of private instruction in Colloquial Moroccan Arabic (or Darija), and a ‘homestay’ with a Rabati family. I came to live in a large house not five winding medina streets away from my school, and became part of a household that consisted almost exclusively of women. At its center stood lalla Khadija,[1] a stout woman in her sixties who came from a time and place where birth dates were not yet recorded, and girls were not yet sent to school. Two of Khadija’s children still lived at home: two daughters, who were temperamental opposites of one another in many ways but shared the common fate of being an unmarried Moroccan woman in her late thirties. The household also included one of Khadija’s grandchildren; her oldest son’s oldest daughter. Together, these four women took care of the cooking and cleaning, and cared for Khadija’s husband, a man about 20 years her senior and no longer capable of much movement.

The lack of privacy in the house facilitated my quick integration into the life of this family. I slept in the living room with the two daughters, assisted with the cooking and baking, helped Asmae, Khadija’s eighteen-year-old granddaughter, with her English homework and wardrobe choices, and spent evenings in the common room, reviewing Arabic vocabulary as the women of my family tuned in to their favorite Turkish soap operas. The family had never showed much interest in my language-learning efforts – until, one evening, my homework material caught the attention of Manal, the oldest of Khadija’s two single daughters. It led to a curious conversation that significantly changed the family’s impression of me and of my purpose in coming to Morocco.

It was about 7 PM, and I was in the living room reviewing flash cards – my preferred method for drilling vocabulary. Manal had just returned home from her small caftan workshop around the corner, and entered the room to change from outdoor clothes back into her pajamas. She said a quick hello, asked me how my day was, and then announced she was going to make us some coffee – but just as she was about to head for the kitchen, her eye was caught by the deck of cards I kept flipping through. Suddenly curious, she turned back to me and asked what I was doing.

“This is how I learn new words,” I explained. “I write the Arabic word on one side, and on the other is the English translation.” I flipped the card over to illustrate.

“Can I see?” she queried, and approached. I handed her a few cards and she studied them intently, a knot slowly twisting across her eyebrows. I remember worrying, self-consciously, that she might not be able to decipher my juvenile Arabic handwriting. Then she shook her head and turned to me.

“This word here is spelled wrong,” she stated in a schoolteacher voice. She sat down beside me on the sdari[2] and reached for the pen that lay on the table in front of us.

“See? There should be a long alif here in between the lam and the qaf,”[3] she corrected. “Like this.” She took the pen and added the alif’s long vertical stroke to the word on the card. I was confused, having just been taught how to spell the word in question that very afternoon. But Manal moved on to card number two. Again, she detected a spelling mistake, and added another missing alif. I looked on, slightly bewildered.

This continued with a few more cards. With each added alif, Manal sighed more deeply, and my bewilderment grew larger. Finally she turned to me. Incredulously, she demanded, “This is what they’re teaching you??”

Then suddenly it dawned on me: she must have assumed I was learning Fusha, or Modern Standard Arabic, rather than the Moroccan dialect. “Oh, wait!” I cried out eagerly, relieved to have identified the source of confusion. “These words are not Fusha, they’re Darija,” I explained, hoping that this clarified the situation.

But she simply looked at me, silently. The knot in her eyebrows showed no signs of disappearing. Then finally she exclaimed, with a mix of surprise and disgust, “You’re learning Darija? Why? Darija is bad, it’s no good!”

A little taken aback, I asked her why. Why on earth would she react this way to the news that I was learning her native language? I had expected at least a little bit of enthusiasm.

“Because it just is. Fusha is just better, it’s the ‘true’ language,” she explained, accompanying her words with heavy arm gestures to convey to me some of the solidity and weight that Fusha seemed to carry in her mind’s eye.

“Darija isn’t spoken right,” she then elaborated, and added an example. “It shouldn’t be tlata; it should be thalatha.” And as the hard ‘t’s of her colloquial dialect made room for the lyrical ‘th’s of Standard Arabic, the scowl on her face smoothed over into an expression of deep satisfaction.

In fact, the differences between Fusha and the Moroccan dialect are many. Fusha, or Modern Standard Arabic, is the contemporary version of Qur’anic Arabic. It is the lingua franca of the Arab world, but native language to none. As is true for all Arabophone countries, the language of daily communication in Morocco is a dialect – a form of Arabic weathered by the test of time, foreign influence, and the transformative process of linguistic evolution. Moroccans refer to their particular dialect as ‘Darija’, and its most noticeable departure from Fusha (aside from the addition of French and Berber loan words) is arguably its pronunciation. To the untrained (and even to the beginning student’s) ear, it often sounds as though speakers of Moroccan dialect have eliminated all vowels from their words – which would explain Manal’s diagnosis of a deplorable lack of alifs in my spelling.

Moroccans agree that no dialect is as far removed from the standard Fusha as their own – and that, in consequence, it is all but incomprehensible to other speakers of Arabic. Nevertheless, most Moroccans deny their dialect the status of ‘real’ language – a sentiment reflected by the late king Hassan II’s choice to designate Fusha, rather than Darija, the country’s official language.[4] As Manal’s comments illustrate, Moroccans consider their dialect to be somewhat of a bastard child. It is the language of mundane, daily activity. Of bargaining at the market, of chatting about the weather, of light banter with friends. Fusha, on the other hand, is reserved for discussion of loftier issues such as religion, literature, or politics – communicative settings perhaps rare enough to have withstood the effects of linguistic evolution. Darija has no literary tradition of its own, and has no official rules of grammar and orthography. Despite my attempts at spelling Moroccan vocabulary, Darija is, in fact, very much an oral language. And by extension of all this, learning Fusha is considered a highly respected endeavor (because it is the gateway for knowledge of the Qur’an, of literature, and of Islamic jurisprudence), while most Moroccans do not consider their dialect worthy of real study.

In consequence I was unable to explain to Manal my reasons for choosing to learn the dialect – at least not in a way that satisfied her strong feelings on the matter. She was not swayed by my purported wish to be able to “talk to Moroccan people.” Why not talk to them in Fusha, she offered in rebuttal. Moroccans would be able to understand, and as an added bonus I’d be able to talk to people outside of Morocco, as well.

Despite her disagreement with my choice, Manal did finally seem to accept the fact that I was learning Darija, and shared the news with the rest of the family later that evening, at dinner. Although the rest of the women were less outspoken about the issue than Manal had been, I still received no positive reinforcement – until Assia, Manal’s younger sister, declared, “well, this means that we can speak Arabic with you now.”

Though I had occasionally tried out my newly learned Moroccan vocabulary on the family, they had, until that moment, always spoken French to me. But Assia’s pronouncement occasioned an immediate departure from that: for the rest of the evening they resolutely addressed me in Darija, and tested my vocabulary by pointing to random items on the table and asking me for a definition. Every answer, right or wrong, led to great laughter and comments of encouragement.

That night, as I wrote in my field notes, I tried to make sense of this strange interaction. What did Assia mean, that now they could speak Arabic with me? Was Fusha not Arabic too? In fact, didn’t Manal’s reaction suggest that Fusha was much more ‘real’, as far as Arabic goes, than Darija? Why did they want to speak Darija, but not Fusha, with me?

As I came to discover in the months that followed, the answers to these questions have to do with the particular role that language plays in Moroccan culture, politics, and constructs of identity. I am not a linguistic anthropologist, and the purported topic of my future dissertation is quite unrelated to the issue of language. However, living in Morocco over the past eighteen months has taught me that language, in this society, is intimately connected to definitions of what constitutes authentic ‘culture’, to notions of status, and to decisions about who belongs, and who does not.

My host family’s reaction to the discovery that I was learning Darija reveals a love/hate relationship with their dialect. It is not considered ‘real’ or worthy of study, but nevertheless it is theirs, it is the language in which they are most comfortable, and it is intimately connected to their culture and traditions. Though Fusha is often placed on a pedestal as a kind of ‘pure’ and ‘ideal’ Arabic, it is a language that the average Moroccan only masters passively. It is taught in school, and it is heard on radio and television; most Moroccans will thus understand anything said to them in Standard Arabic. Speaking it, however, would be the equivalent of an American speaking Shakespearean English. Fusha, one might venture to argue (from a linguistic standpoint at least), is no more ‘their’ language than French would be.

Moroccan Arabic, in contrast, is entirely ‘theirs’. It may not be a real language, but speaking it signals a kind of cultural belonging, or insiderness in a way that Fusha cannot. I had noted this difference in value before, when I first came to Morocco in the spring of 2005. I was in Fès for a period of three months, and took an intensive course of beginning Darija, followed immediately by an intensive course of intermediate Fusha. Whereas topics of discussion in the colloquial class included Moroccan customs, traditions, and superstitions, the Fusha classes focused on pan-Arab politics, Middle-Eastern history, and Qur’anic theology. Feeling a growing disconnect from the Moroccan context during that last course, I remember regretting my decision to switch from dialect to standard Arabic.

In late 2008, the shift in language of communication likewise brought with it a shift in subject matter. Communication with my host family became at once much more extensive, and much more context-related. Whereas before they had answered my curious questions about Moroccan customs only superficially, the women now began to explain things to me with enthusiasm, and to include me in their activities – claiming that it would be a ‘learning experience’ for me. Before the shift, they had warned me that I wouldn’t be able to handle witnessing the sacrifice of a sheep during the upcoming ‘Eid leKbir. But now, now that we were speaking Darija, I was not only allowed to be present, but was in fact charged with documenting the whole day with my digital camera. It was, in short, as though a door had been opened, and I was finally allowed inside the private life of this family. The realization that I was learning Darija seemed to have utterly changed the family’s impression of me. Before, I had simply been another foreign student, here to learn a language and then go back home. Their preference for speaking French with me at that time suggests an a priori assumption of an insurmountable communicative and cultural divide; a fundamental difference, an inherent outsiderness on my part. The fact that I was studying Darija, however, seemed to have led them to discern in me a potential for immersion, learning, understanding, and perhaps even integration. Perhaps my interest in Darija confirmed for them the sincerity of my interest in Moroccan culture – and their ability to speak to me in dialect allowed them to talk to me about it in its own terms. Darija may be no Fusha, but it is the vehicle of Moroccan culture.[5]

---

[1] Lalla is the Moroccan word for “lady,” or “mrs.” It is commonly followed by a first name. All first and last names used in this paper are pseudonyms chosen by the author.

[2] A sdari (pl. sdader) is a Moroccan sofa: a thick and firm mattress-like seat that rests on a wooden base, and a back rest of loose cushions. Sdader typically line all four walls of a Moroccan sitting room.

[3] An alif is an ‘A’, a lam an ‘L’, and a qaf is a ‘K’ pronounced deep in the throat.

[4] History books argue that this choice was driven by a desire to align Morocco with pan-Arab political movements that were emerging at the time in the Middle East.

[5] This was again confirmed a few weeks later, at a friend’s wedding. I had commented to Manal on something, and had switched back into French because I was unsure of the right Arabic word. She turned to me and told me in no uncertain terms that we had to speak ‘Arabic’ right now, because we were at a wedding, and that was a ‘Moroccan’ event. French would thus be inappropriate.

In Need of a Listening Ear

“Charlotte,” she calls out. “Charlotte, shoufi,” look at me.

I turn towards her and she stands there in the middle of the room, a seductive smile on her face as she dances to the sound of Egyptian pop. She’s feeling the rhythm with eyes half closed.

“Like this, see?” she says and puts her hands on her hips for emphasis, swaying back and forth to the beat. She motions for me to join her. “Come here, try it. Leave your jacket.”

I get up off the couch, and join her in movement. She regards me critically as I attempt to imitate her movements, then laughs. “Hey, come and see!” She calls out to people walking by outside. “Charlotte’s belly dancing!”

***

I first talk to Rachida one Wednesday morning, two days after her hospitalization. On the day of her admission she’d been wearing a black Saudi-style abaya* with matching headscarf; twenty-four hours later, the Islamic clothing has been replaced by a leopard-print track suit. Diamond studs across the chest spell out “Chanel.” She has joined the other patients’ regular grooming activities, and now walks around with her hair blown out into large curls, her lips painted a deep pink, and her eyes accented with heavy lines of kohl.

Within ten minutes of meeting her, Rachida has filled me in on the pertinent parts of her biography. She lives in a southern Moroccan town with her husband and three children, and she is a housewife. With regard to that last fact, there are three things I need to know. First of all, that she is highly intelligent – she could have pursued a higher education, had she been given the opportunity. Secondly, that she is a great cook (which prompts her to describe, in elaborate detail, the particular dishes she’s mastered). And thirdly, that she hasn’t lifted a finger in the house ever since she fell ill, now three years ago. “Je fais rien – du – tout,” she summarizes for emphasis.

She doesn’t know how or why she got sick. It simply happened one day, mysteriously and suddenly. For three long years she was incapacitated – but she’s definitely feeling better now, she lets me know. She tells me she’s “farhana,” happy, on the ward: everyone is nice, there’s always someone to talk to, and everything is taken care of (though the food doesn’t compare to what she whips up at home, of course).

She’s invited me to her room, and we sit on her bed as she shows me pictures of her family, describing each of her loved ones in the most positive of terms. I casually remark that her husband bears a striking resemblance to her late father: both were military men who seem to fulfill all the requirements of ideal Moroccan masculinity. She’s spoken of both with tenderness in her voice. But here I seem to have overstepped some boundary. “Not at all!” she exclaims with a vehemence that makes me fear I might have sullied someone’s image. Her father was a great man, she assures me; a truly great man. Her husband, on the other hand, is revealed to be a jealous grouch. Like all men from the south, he is conservative and traditional; it’s because of him that she stays at home, wears a headscarf, and keeps her distance from unknown men.

And suddenly she suggests that this stifling home environment is the actual cause of her malaise. She isn’t happy in her southern town, she explains; she feels quite literally like a fish on dry, desert-like land. She would much prefer to live in a place like Rabat, where women have jobs, and go to the beach whenever they like. She’s glad to be far away from her husband for the time being. He’s not allowed to visit her (doctor’s orders), but she doesn’t mind one bit. This way, she says with a smile, she can truly relax and get better.

Rachida’s eagerness to talk compels me to recruit her as a research participant. And she is indeed happy to be interviewed – yet the conversations that ensue are not nearly as rich or productive as I had hoped. The thing is that Rachida’s stories are a bit like a pre-recorded message; no matter what questions I ask, she tells me this same basic narrative over and over again. Behind this story is a mental wall that I simply cannot manage to break through. She repeatedly tells me that she is entrusting me and my recorder with her deepest secrets, but I get none of the subjective detail or emotional depth that I had expected to find.

It takes me a while (and quite a bit of self-doubt about my qualities as an interviewer) to realize that this is the very source of Rachida’s problem. It seems that she may have been right on the money when she blamed her environment for her illness. Rachida has lived her life in a time and place that discouraged women’s freedom to express their personal feelings and desires. She is hermetic about what goes on in her mind not because she does not want to share, but because she quite simply never learned how to do so.

Nevertheless, everyone needs an outlet – everyone needs to vent. And so in the absence of words, Rachida communicates with her body. Her malaise manifests itself to her as fatigue, depression, or a momentary lapse in consciousness that she explains as a neurological anomaly. She is a hypochondriac, and her medical file contains three inches worth of lab reports, x-rays, and MRI scans that all come to the same conclusion: her problem is mental, not physical.

Her inability to communicate verbally also explains her need for attention and tendency to seduce. Stuck in an impossible position, between a lack of words and the uncontrollable need to finally be heard, Rachida craves human interaction and a bit of understanding. But unable to ask for it directly, she’s learned to attract it by using the physical power of her femininity.

Rachida is, in a word, hystérique. The days of Freud are long gone, and the term “hysteria” no longer appears in the international diagnostic manuals currently in use – but it is alive and well in Morocco. The women’s ward always houses a few patients with hysteria; women just like Rachida, who have no other way to speak than through their bodies.

The doctors are stern with Rachida. She is taking anti-depressants, but the dominant aspect of her treatment involves a kind of behavioral therapy. Rachida must learn to be more emotionally independent, and she must learn to talk about her feelings. The doctor meets with her every day, and patiently yet persistently attempts to break through her mental wall. But women like Rachida are never allowed to stay at the hospital too long. This so as not to indulge in the ‘secondary benefits’ of hospitalization. Being a patient means being confirmed as being ‘sick’ – and that label entitles one to all kinds of special care and attention. Most patients cannot wait to be cured and discharged. But les hystériques? They couldn’t be happier, right here on the ward, being taken care of by everyone else. In order to ensure that such women still retain some motivation to get better, the staff tries to make hospitalization slightly less attractive – by cutting off certain privileges. This is why Rachida isn’t allowed to have visitors. She’s also not allowed to keep her cell phone with her, and although the staff encourages her to talk, they make sure not to be too available to her.

Luckily I am not a member of the staff, and I can be as available to Rachida as I want. Perhaps I can be a listening ear that doesn’t probe for uncomfortable details, I decide. And so I give up on diving into the depths of her mind, settling instead for easy interaction. Aside from our interviews I hang out with her on the ward’s courtyard, relaxing in the sun. As we sit side by side, she’ll turn to me, put on her nicest smile, and ask, “Comment tu me trouves?” What do you think of me?

I’ll turn, and look at her. And before I get a chance to answer, she’ll hint at the particular kind of compliment she’s looking for that day.

On this particular afternoon, she runs her fingers through her hair and poses a rhetorical question.

“I have nice hair, right?”

I express my agreement, and she continues. It’s perfectly curly, she explains. And no matter what she does with it, it always looks great. It’s just too bad she’ll have to cover it back up with a headscarf as soon as she leaves the hospital…

And off she goes; she has launched herself into another rendition of her biography. I lean back in the sun, put a smile on my face, and simply listen.

* basically, a long, formless black dress

Chatterbox

Hafida is 57, though you wouldn't say so if you saw her. The years seem to have weighed more heavily on Hafida's shoulders than on those of others. The passage of time has etched deep wrinkles across her forehead, and her deep-set eyes betray the depth of her exhaustion. She shuffles around the ward in pink hospital-issued pajama's, three sizes too big for her skin-and-bones frame; with her back hunched forward she’s forever looking down at her feet. She always carries around a big woolen sweater, as though she is planning ahead for an upcoming departure. But other than a dubious brother and a modest pension fund, the doctors tell me there is little waiting for her at home.

"On fait avec," she answers with a sigh and a smile, every time I ask her how she's doing. "On fait avec," 'we do the best we can.' According to Hafida, her best days are behind her. She is old and tired; her life has been reduced to the nostalgic memory of opportunities and experiences that have long since retreated beyond her grasp. She believes she has exhausted her potential, and her candle’s flame has been all but blown out.

The doctors tell me that her “tristesse” is part of her illness. She has schizo-affective disorder, an illness in which the normal manifestation of schizophrenia is compounded by an extreme fluctuation of one’s mood. Yet I cannot help but wonder, who wouldn’t be exhausted after 30 years of hearing voices in your head?

But Hafida is still full of wisdom and stories. As we sit on a bench in the sun, just the two of us, she talks about the important things in life: about love, adventure, and good health. These are the kinds of values, she impresses upon me, of which you don’t realize the importance until it is too late. She advises me to love fully, and to express my feelings. Too many people have locked their hearts, she says. Little do they know that true blindness is not the inability to see, but the inability to feel.

In the same way, our ability to hear means nothing if we cannot listen. When she learns that I am Dutch, she tells me in a mixture of English and rusty German that she made her career as a professor of foreign languages. She speaks at least four different ones – but the most important language of all, she tells me, is “la communication des sourds” - the communication of the deaf. True communication, she explains, requires much more than words. One must be open to, interested in, and understanding of one’s interlocutors. One must always remain curious. In fact, this is the meaning of life: discovery, adventure, and learning. When she was younger, she says, she was like me: as I am exploring Morocco, so she explored Europe. But what you can do, she sighs, when life’s obligations curb your freedom to fly? She impresses upon me the importance of continuing my pursuit of discovery – of never allowing my heart to lock itself into blindness.

***

A few days before her discharge from the hospital, we meet once again on that bench in the sun. We are chatting in our usual mixture of Arabic, French, German, and English, when she unexpectedly turns to me and apologizes for talking so much (little does she know how much I’ve enjoyed listening to her). She wants to know, how do you say “bavard” in English?

“Chatterbox,” I translate.

She nods, and smiles. She likes this word. She is a multilingual chatterbox, she says, who has begun to lose her words. With age, her knowledge is slipping and she no longer speaks any of her languages perfectly.

“Before long,” she concludes with a smile, “I’ll just be an empty box.”

I want to tell her that she need not worry, that she still has plenty of words and stories to fill a lifetime to come – that her candle is not even close to burning out. But I keep this to myself. Nostalgia aside, I’m beginning to realize that Hafida yearns for mental quiet. She has lived a lifetime with an endless stream of verbal commentary running through her mind; I cannot help but think that the prospect of an empty box might finally bring her the relief she’s been seeking.