Scientizing Bangladeshi psychiatry: Parallelism, enregisterment, and the cure for a magic complex

This article combines textual, videotape, historical, and ethnographic evidence to describe the Bangla psychiatric register and its enregisterment. Enregisterment is a process “through which a linguistic repertoire becomes differentiable [and] . . . socially recognized” (Agha 2003:231). The emergence of psychiatric registers in Europe and, later, Bangladesh bore the particular burden of psychiatry’s “magic complex” – its need to convince a skeptical public that its perceived associations with magic and religion were finished, vanquished in part by discursive measures, focused on a scientizing drive. Psychiatric Bangla appears to involve the sort of pervasive use of parallelism normally associated with ritual texts. This indicates a profound hybridity that may contribute to the psychiatric unease epitomized in the magic complex. (Enregisterment, linguistic anthropology, psychiatry, poetics, parallelism, classification, natural kinds, Bangladesh)* I N T R O D U C T I O N This article describes the emergence in Bangladesh of a repertoire of discourse forms associated with scientific psychiatry that attempt to distance it from magic and religion. These forms and their function are related to the emergence of psychiatry in Europe and the hegemony of certain centers of knowledge production vis-à-vis peripheries like Bangladesh. Beyond a brief consideration of this European background, I shall focus on the process of enregisterment, the Bangla psychiatric register, and its peculiar relationship with parallelism. The growth of medical and psychiatric registers can be regarded as so many skirmishes in the long border war among magic, science, and religion; they presuppose the history of European discourse influenced by Bacon and Locke, whose struggles to invent a modern scientific language were defined both by striving toward “purity” of boundaries and much “hybridity” (among nature, society, and language; among magic, science, and religion; etc. [Bauman & Briggs 2003]). The Bangladeshi psychiatrists I know react to rural patients and their families as they do in part because of such boundary0purification struggles. Issues of Language in Society 37, 91–114. Printed in the United States of America DOI: 10.10170S0047404508080044 © 2008 Cambridge University Press 0047-4045008 $15.00 91 discourse – particularly, the production and maintenance of a scientific register – are at the heart of psychiatry’s struggle, and patients become caught up in it. In Bangladesh this appears as a struggle to “modernize” the country, its culture, its people (especially rural people), its language, and its psychiatric profession, inter alia. Psychiatry struggles with its own complex – a “magic complex” – because of its tenuous reputation (Rosoff & Leone 1991:321; Perlin 1997; Lee 1999:354), its primary challenge (revealing the mind’s secrets), and its ultimate task (curing mysterious ills). As a complex or neurosis this involves attraction – as when Jean-Martin Charcot (1825–1893), “last of the great nineteenth-century French psychiatrists,” admitted he had long sought “the mechanism of [the] production [of faith cures] in order to make use of its power” – and a need to deny the attraction. The same Charcot took such Adam-like delight in naming new psychiatric entities that, at least in Freud’s opinion, he saw himself as a kind of new Adam (Goldstein 1987:384) – hardly a Pure Science role model. Agha (2004:24) defines a register as “a linguistic repertoire that is associated, culture-internally, with particular social practices and with persons who engage in such practices.” The “medical register” and its role in buttressing the credibility of expert witnesses have been explored in this journal (Matoesian 1999:519). The term “enregisterment” “refers to processes through which a linguistic repertoire becomes differentiable within a language as a socially recognized register of forms,” processes that produce cultural value, “processes through which the values of cultural forms are formulated, maintained and communicated across social populations,” as in “the emergence and spread of a prestige register” (Agha 2003:231). Agha describes the “Received Pronunciation” of British English, its demographic spread, and its function as a gold standard in an increasing array of situations in the UK. Professional registers can also confer prestige. Whereas some depict them as esoteric, members of the public occasionally borrow from the emerging Bangla psychiatric register, as has happened with psychiatric registers since the 1810s, when the newly minted psychiatric term “monomania” quickly entered French popular culture (Goldstein 1987:153). P S Y C H I A T R I C P R E S T I G E A N D P S Y C H I A T R I C N O S O L O G I E S Classifying is central to culture, to what languages offer as semanticoreferential systems, and to what speech interaction does (Silverstein 2004). Moreover, the self-conscious development of a set of labels, knit together in hierarchies, uniquely characterizes the self-invention of the natural sciences in early modernity. Peculiar to modern psychiatric nosologies is a special attraction to natural kinds. Psychiatry’s science envy pertains to its inability to establish with any certainty that it deals with natural kinds such as species, chemicals, and water, which are indifferent to being classified as such. Psychiatry deals instead with interactive kinds, which are conscious of, and affected by, being classiJ A M E S M . W I L C E 92 Language in Society 37:1 (2008) fied as they are. Hacking writes, “There is a constant drive in the social and psychological sciences to emulate the natural sciences, and to produce true natural kinds of people. This is evidently true for basic research on pathologies such as schizophrenia and autism.” But this is an unattainable dream; these cannot be natural kinds, because “new knowledge about [human groups] . . . becomes known to the people classified, changes the way these individuals behave, and loops back to force changes in the classifications and knowledge about them” (Hacking 1999:105). The frustrated drive to emulate the natural sciences becomes envy, because to be seen as more scientific is to be more highly valued (Harré 1985:182), particularly in the context of international peer relations. In what appears to be an attempt to ward off the label “backward” for their national psychiatric professions (Lee 1999:354; Pacific Rim College of Psychiatrists 2006), Asian psychiatrists increasingly conform their labeling practices to cosmopolitan norms as embodied in the DSM (the Diagnostic and Statistical Manual, American Psychiatric Association 2000), the handbook of psychiatry and allied professions. In clinical practice (Berkenkotter & Ravotas 1997:264), psychiatric taxonomies are used as “membership categorization devices” (MCDs), Harvey Sacks’s (1972) term for the category sets, and accompanying rules of application, by which people routinely describe others (Goodwin 2006:264). MCDs include the noun phrases that might be embedded in a psychiatrist’s declaration, “You are suffering from [illness label].” Properly invoking membership categories that stand a chance of being recognized as rigorous is crucial to science, medicine, and psychiatry (in descending, nesting order). T H E C O I N ( A G E ) O F T H E R E A L M : P O W E R A N D T A X O N O M I Z I N G I N P S Y C H I A T R Y ’ S H I S T O R Y According to the Oxford English Dictionary, “psychiatry” appeared in English (borrowed from German; Goldstein 1987:4) only in 1846, and “psychiatrist” in 1890. Previously, these marginal figures had been called “alienists” or “mad doctors” – a profoundly ambiguous term. Throughout the 19th century, mad doctors struggled to distance themselves from the aura of magic, in part through the discursive sorts of reform instantiated in James Braid’s writing: I was led to discover the mode I now adopt with so much success for inducing this artificial condition of the nervous system, by a course of experiments instituted with the view to determine the cause of mesmeric phenomena. (1998 [1853]:61, 60; emphasis added) Braid was the coiner of the term “hypnotism,” a technique important to early psychiatry, but whose longer history is associated with sorcery, magic, and demonology (Hayward 2004, Orne & Hammer 2006). Discursive reform was tied to enregisterment processes that, in psychiatric French, English, German, and other languages were bound to genres like mediS C I E N T I Z I N G B A N G L A D E S H I P S Y C H I AT R Y Language in Society 37:1 (2008) 93 cal journal articles (an important means of establishing and circulating scientific knowledge), hospital records (typically the source of the articles), and psychiatric textbooks (an early example is Pinel’s, 1801). Coining new disease labels has been central to this process at least since the 19th-century French Idéologue doctors – practitioners of “the science of ideas,” “medicine of the imagination,” or “moral treatment,” such as P-J-G. Cabanis (1757–1808) and Philippe Pinel (1745–1826) (Goldstein 1987). In Pinel’s or even Charcot’s era, diagnosis was characterized by “vagueness” (Drinka 1984:40). It was not until the time of the German psychiatrist Emil Kraepelin (1856–1926) that category specification took off. The trend has only intensified since Emil, brother of the German biologist Karl Kraepelin (1848–1915), transformed psychiatry by subjecting it to the brothers’ mutual interest in biological taxonomies (Weber & Engstrom 1997:383). Psychiatry’s focus on classifying illnesses as natural kinds emerged with the publication of the 1899 edition of Emil’s textbook on clinical psychiatry (Kraepelin 1899). That edition gave special attention to “dementia praecox,” later baptized “schizophrenia.” The Kraepelinian revolution spawned new scientizing uses of language that came to define the psychiatric register. Registral consequences are still being felt through successive iterations of the DSM, in use to a greater or lesser extent around the world. A key marker of the psychiatric register in Bangla and English One more piece of history outside of Bangladesh is important to mention before focusing our attention there, and that pertains to the rise in English of a certain progressive use of one verb in particular. The enregisterment of medical and psychiatric English was not completely cut off from popular usage; certain phrases, however, came increasingly to index an ever more prestigious medical profession – particularly the construction “you are suffering from . . . .” The first Oxford English Dictionary entry for “suffer” is not the strictly subjective sense of the term, but rather, “to undergo, endure,” as in to undergo “(c) a blow, wound, disease.” (The denotation of the Bangla counterpart bhugis similar; Ali, Moniruzzaman, & Tareq 1994:616). The third OED entry is “To undergo or submit to pain, punishment, or death,” e.g., “(b) from . . . a disease or ailment.” By the end of the 19th century, the medical associations of the progressive form “you are suffering from” were strong enough that literary instances cited in the OED are consistently medical. The phrase appears in the fiction of Conan Doyle, Kipling, and George Eliot either in the mouths of medical doctors, or (in Kipling) in an apparent parody of the medical voice. Dr. Tertius Lydgate speaks thus to Rev. Causabon in Eliot’s Middlemarch: “I believe that you are suffering from what is called fatty degeneration of the heart” (1986 [1871–2]). The progressive aspect emphasizes the immediacy (and, perhaps, the short-term duration) of what the semantic patient is enduring. (This holds true in Bangla as well.) J A M E S M . W I L C E 94 Language in Society 37:1 (2008) In order to contextualize the Bangla discursive forms I analyze below, I now turn to a thumbnail ethnographic sketch of Bangladesh. E T H N O G R A P H I C C O N T E X T Bangladesh is an agrarian nation undergoing rapid change in a form of capitalist development unlike what its larger South Asian neighbor, India, experienced. Specifically, Bangladesh’s development trajectory is marked by a radical dependency that sets it apart from India’s mid-20th-century attempts at economic0 cultural self-sufficiency. India has a thriving Ayurvedic medicine “industry”; there has been no strong movement to preserve Bangladesh’s Ayurvedic medical tradition. A relatively young female psychiatrist who collaborated with me, whom I call “Dr. Pushpu,” 6 tells me that she has seen a recent upsurge in cases of psychosis in Bangladesh. She attributes it to rapid social change, including the flooding of Bangladeshi television with American cartoons. The rural Bangladeshis I’ve met tend to explain unusual human behavior not (or not just) as the result of psychological states but as the effect of ‘sorcery objects’ (one possible sense of tābij ), ‘loose wind’ (ālgā bātās, sometimes understood as spirits), or frustrated desires (Wilce 1998). When someone goes mad, family members may subject him or her to a ritual sweeping, dusting, and blowing – jhārphuk – or procure for the sufferer a protective tābij ‘amulet.’ The vast majority of Bangladeshis have nothing to do with psychiatry; they live a good day’s journey from the nearest psychiatrist, and their knowledge of the world has little in common with Dhaka psychiatrists’ knowledge (Wilce 2004). Along with other media, magazines provide a means by which modern “technologies of self” (Foucault 1990) – including psychiatry and psychology, two of what Rose calls “the psy disciplines” and their models of self – can enter popular discourse. In the West these disciplines have “disseminated themselves rapidly through their ready translatability into programs for reshaping the self-steering mechanisms of individuals, whether these be in the clinic, the classroom, the consulting room, the magazine advice column, or the confessional television show” (Rose 1996:34; emphasis added). In India one can also read magazines devoted to the psy perspective on the self, some of which began publication decades ago. General-interest magazines that have an even wider circulation in India have for many years carried psychiatric advice columns (Halliburton 2005). Only in 1998 did a magazine appear in Bangladesh that popularized a psy approach to the self – Manabigyān ‘Psychology.’ It reflects the vision of “Dr. Minaj,” its founder and publisher – a psychiatrist who completed postgraduate training in England – and the circle of psychiatrists he has trained. Dr. Minaj is shaped by his engagement with global psychiatry (primarily through attending regional conferences) and his scouring of the Internet for articles (importantly, in English) to translate for Manabigyān. Dr. Pushpu, mentioned earlier, cofounded and helps edit the magazine. S C I E N T I Z I N G B A N G L A D E S H I P S Y C H I AT R Y Language in Society 37:1 (2008) 95 Manabigyān’s readership is impossible to count, but surely well above the 9,000 copies of each monthly issue being printed in 2000 when I interviewed Minaj, since each copy would likely be read by several people. Readers send letters to its Parāmarś;o Pātā ‘Advice Page’ from all over Bangladesh, seeking help with their own or their loved ones’ problems. The psychiatrist-editors responding to them reframed samasyā ‘problems’ as mānasik rog ‘psychiatric illnesses’ 7 – a task crucial to this enregisterment process, for this reframing (i.e., medicalizing, translating problems from the “lifeworld” into diseases in the “world of medicine”; Mishler 1984) epitomizes medical registers in general. Letter writers might well expect and seek such reframing, given the nature of the magazine. More remarkably, over the course of the first eight issues (December 1998 through June 1999), they themselves increasingly used the features of the psychiatric register, particularly nosological labels. Especially in the first few issues, the labels were often English, reflecting Minaj’s various international engagements. Mixing English (especially English membership categories) with Bangla in order to make the psychiatric register scientifically pure was only one of the editors’, and the register’s, paradoxical “tools.” The magazine is a site of interest as an agent of cultural change. Dr. Minaj and his colleagues had an openly missionizing attitude about the magazine and their work in general, possibly motivated by a sense of Bangladesh’s “backwardness.” To have their compatriots speak of madness as pāgalāmi ‘craziness’ (rather than manarog ‘mental illness,’ or mānasik rog) – or even to hear that some of them fall prey to spirit possession – challenged the purity of the register that they struggled to establish. M E T H O D A N D T H E O R Y During winter break, 2000–2001, I carried out three weeks of urban fieldwork in collaboration with Dr. Pushpu and other psychiatrists who are part of the Manabigyān circle. Old contacts in Bangladesh introduced me to Dr. Pushpu, who in turn introduced me to Dr. Minaj and his collaborators at Manabigyān. Later in this period the staff gave me copies of the magazine’s first three volumes. I had previously carried out doctoral fieldwork in rural Bangladesh focused on complaint, eventually working with many who were locally labeled pāgal ‘mad’ (1991–1992; see Wilce 1998). This time I met patients, always accompanied by family members, in psychiatrists’ chambers. I developed a joint informed consent procedure with the psychiatrists, asking patients and families whether I could arrange a home visit to videotape a dinner conversation. Once, Dr. Pushpu, a patient, and her family allowed me to videotape Pushpu’s “home” visit (caveat explained below), the focus of Transcript 4. Thus this article analyzes two sorts of discourse data: videotaped interactions and advice columns. With the assistance of a graduate student who is highly literate in Bangla, I transliterated, translated, and analyzed the first 111 exchanges appearing in J A M E S M . W I L C E 96 Language in Society 37:1 (2008) Manabigyān’s Advice Page (an exchange consists of reader’s letter and editor’s answer). I focus on the impact of the editors’ responses in shaping a scientific Bangla register. Then I transcribed and analyzed eight videotaped encounters involving families and myself, using techniques combining conversation analysis and semiotic-poetic analysis, again receiving help in transcribing and translating difficult portions from the Bangladeshi student. The 111 exchanges comprised Manabigyān’s first eight issues, a corpus of 15,800 words. Why should an account of the enregisterment of a scientific variety of Bangla center on its poetics, particularly the parallelism I trace in Transcripts 1– 4, below? The role that parallelism – poetic juxtapositions of paired elements (Fox 1988:3) – turned out to play is striking. “Densely laminated” or “hypertrophied” layers of parallelistic structure are associated with “full-tilt” ritual, even if “ritualization” is by degrees a feature of all speech events (Silverstein 2001, 2004). Yet, as Silverstein points out, building on a long line of argument (see Irvine 1989), all acts of naming (and, I might add, as Kripke 1972 and Putnam 1975 show, particularly scientific naming) are ritual events. Hence my focus on “baptisms” (Kripke’s term) or rebaptisms of English nosological labels for use in the (hybrid-) Bangla psychiatric register. These baptisms are embedded in parallelistic structures. The study of parallelism began with Robert Lowth (1710–1787). Scholars like Lowth associated such poetic devices with Europe’s spatiotemporal Others (Bauman & Briggs 2003). It is important, therefore – to the extent that it is empirically justified – to explore parallelism’s role in the enregisterment of a scientific variety. The linguistic anthropological analysis of parallelism has shifted since Jakobson’s time – though he very much prefigured the shift (1987:135) – from static to dynamic understandings of text (i.e., to “emergent entextualization”), and to an increasing focus on how emergent textual patterns achieve certain ritual ends. Silverstein uncovers the gradually building effect of Lincoln’s layering of multiple forms of parallelism in the Gettysburg Address (2004:48). Elsewhere, he reinterprets one of Fox’s (1989 [1974]:74–76) examples of parallelism in terms of emergent entextualization: “The dynamic figuration here – the diagram emergent over the real time in which the message is articulated – is, of course, what makes this ritual text ‘work’ as effective social action” (Silverstein 2004:627). In his analysis of the transcript of a dyadic interaction, Silverstein demonstrates the close intertwining of what he calls the “interactional text” – the record of how participants mutually constitute each other, and themselves, in give-andtake, vis-à-vis “relational positions” – with the “denotational text” or information structure. When the latter consists to any significant extent of identity categories, the mutual involvement of the two “texts” is obvious (Silverstein 2004:622–25). The dual-text approach intimately connects the analysis of parallelism to a model of how the social order is constituted and reconstituted in interaction. Denotational texts, unfolding as they do in the binaries of “then” and “now,” “there” and “here,” provide rich resources for interlocutors to link each S C I E N T I Z I N G B A N G L A D E S H I P S Y C H I AT R Y Language in Society 37:1 (2008) 97 other with denoted identity categories contrastively laid out vis-à-vis deictics. One often finds “semantic and structural parallelism . . . across a series of deictic verbs, demonstratives and locative adverbs” in the worlds’ languages (Sidnell 2005). Given that “most languages seem to make a basic distinction between proximal [and] distal” deictics (Sidnell 2005) that can be described as a pervasive structural duality, we have here a built-in foundation for parallelism (as poetic juxtaposition of paired elements). It is the foundation for antithetical parallelism in Transcript 4. A final note on parallelism in the context of explicitly modernizing discourse. Contemporary social scientists critique the simplistic binaries of modernization theory: modern vs. traditional, corresponding with a whole set of antonyms including urban vs. rural and Gesellschaft vs. Gemeinschaft. Yet, as valid as the critique of modernization discourse is, we cannot ignore those instances when local actors adopt it (Ferguson 1999:83–84). In contemporary Bangladesh there are many ways of speaking about urban and rural life, or allopathic and other forms of medicine. But one way of speaking about such things that is common, at least in Dhaka, draws on the antithetical pairs of modernization theory. I wed this broad recognition with the tools of poetic-semiotic analysis in my approach to parallelism. T E X T S A N D A N A L Y S E S It is best in introducing the letter-exchanges to present a simple one, in translation, which moves quickly through the structural features common to all. (1) Exchange in fifth issue of Manabigyān Letter 1 In the top of [my] head 2 there is a grabbing or full sensation. 3 It feels hot, 4 and even if I pour water on it 5 the heat doesn’t abate. 6 Toward the neck there is a sensation like pain. 7 Little relief comes when I sleep. 8 What is the solution? Editors’ Advice 9 All the physical problems 10 of which you have written have a source 11 in psychological illness (mānasik rog). 12 You are suffering “depression.” 8 13 There is some anxiety mixed with it. 14 Take 20 mg. Prozac in the morning 15 and Lexotanil (3 mg.) one capsule at night. 16 After several weeks, visit a psychiatrist. Exchanges in Manabigyān move quickly along in a kind of replication of Bangladeshi psychiatric encounters. The clinical encounters I witnessed involving psychiatrists in the Manabigyān circle were under five minutes, J A M E S M . W I L C E 98 Language in Society 37:1 (2008) proceeding quickly to a diagnosis. Each advice column response tends to begin with a salutation, and then move to a revelation that may (re)baptize a psychiatric illness label (“you are suffering from x”), sometimes followed by an even more dramatic revelation, viz. where this problem “comes from,” (e.g., the “unconscious mind”). Next comes professional advice (“get psychotherapy” – specifically, after a few issues, at the new Manabigyān Counseling Center), an underscoring of psychiatry’s authority in these matters, and finally, prescribing psychiatric prescription drugs in this version of telemedicine. An editors’ response seven months later (Figure 1) entails greater elaboration, just as in the letter that provoked it (372 Bangla words vs. 29 Bangla words in the letter translated above). “Hashemi’s” letter and its answer appeared in Manabigyān’s seventh issue. There are several reasons to analyze it. First, writing from a major urban area, Hashemi reveals (fatefully) that he has sought treatment from an Unani (Islamicmedical; see Liebeskind 2002) clinic. This prompts the editors to attend to the boundary between science and religion. Although Hashemi indicates that Unani failed, the editors respond as though psychiatry’s authority needed asserting visà-vis the ongoing availability of religious healing. Second, true to form, the response includes the formula “you are currently suffering from . . . .” Finally, it is rich in parallelistic structure, allowing us to see in its entextualized figuration the paradox of modernist psychiatrists’ magical-poetic vanquishing of “backwardness.” The commitment of the Manabigyān circle to psychiatric modernism shows itself, ironically, in the unfolding poetics of this text. In particular, its three chiastic layers of antonymous parallelism (Jakobson 1987) bear the modernist message. The outermost bracket connects the editors’ accusation of naïveté, from line 4 – surely good grounds for Hashemi to feel hatās ‘discouraged’ (line 34) – to the closing exhortation not to feel discouraged (34) – a paradox at best! Thus the first antithetical pair. Moving inward – building parallelism – the next bracket connects Hashemi’s condition “now” (‘ensnared’, lines 7–8) to a promised improvement in the ‘long-term’ should Hashemi pursue a full scientific psychiatric treatment (lines 21–22). We come, finally, to the literal crux. As a rhetorical tool, chiasmus (a cruciform or X-like pattern of entextualization) focuses attention on the crossing point (cc) of a pattern (abccba) – in this case, the bracket connecting lines 11 and 21. The climactic contrast is between the two clashing agents: Unani medicine (line 11), which has trapped Hashemi (line 8) due to his naiveté (line 4, i.e., his backwardness or traditional orientation), and truly scientific, psychiatric medicine (line 21). There is an intriguing paradox in the representation of the psychiatric authorities from whom Hashemi should receive therapy (line 21). The editors exhort Hashemi (and in some sense all of Bangladesh) to turn from Unani medicine0 tradition0deception to psychiatry0modernity. Yet the word tattābadhāne, the S C I E N T I Z I N G B A N G L A D E S H I P S Y C H I AT R Y Language in Society 37:1 (2008) 99 figure 1: Response to Hashemi’s Letter. J A M E S M . W I L C E 100 Language in Society 37:1 (2008) ‘guardianship of special knowledge’, also resonates with tradition, particularly esoteric Hindu tradition. The poetic climax creates a modern-traditional hybrid idiom at the very crux of the editors’ entextualized efforts to purify Bangladesh of the taint of tradition. Present and perfective verb forms are underlined and future forms boldface. Note the non-accidental shift from one to the other as the response unfolds. This text, a microcosm of the grand narrative of modernity, dynamically figurates Hashemi’s and Bangladesh’s potential move from a dark past and an entrapped present to the desired future. The progressive unfolding of the editors’ response maps out on the plane of discourse what they attempt to “magically” (i.e., performatively, rhetorically) accomplish on a more worldly or cosmic plane (Wilce 2006), moving Hashemi and Bangladesh from entrapment in lies to the liberation of scientific truth. This text works like other magico-ritual texts; its entextualized movement (of tenses) imitates the cosmic end being ritually enacted – magic! Finally, note the arrows, pointing out the three passages in which the editors stress the long-term nature of the problem and its solution. These passages iconically capture the problem of Bengali tradition that the Manabigyān circle confronts, a recurrent theme of their discourse (as I show, vis-à-vis Transcript 4, below). As the editors confront poor Hashemi’s naiveté, a move perhaps motivated by all psychiatrists’ own awkward position in the history of science – but also related to their own awkward status as Bangladeshi and Asian psychiatrists – they index an abiding concern with temporality. Thus this exchange operates under a powerful paradox, the profound hybridity inscribed in the psychiatric register. The editors reject a premodern determination of the boundary between science, magic, and religion – Unani’s determination – while resorting to lexical tools like tattābadhāne, and semiotic tools like parallelism. The irony uncovered is that the modernist message emerges, in part, in the very sort of unfolding poetics that Fox, in his argument about canonical parallelism, argued was “reserved for . . . the utterance of sacred words, ritual relations, curing, and the communication with spirits” (1989[1974]:84). Note also, however, lines 25–28 of Figure 1 – a crucial textual moment in which the psychiatrists demonstrate their tattābadhāne by revealing from a distance an additional manarog ‘mental illness,’beyond the sexual problem: bi. sannatā ‘depression’. For inventing psychiatric registers has since 1800 entailed baptizing and using new membership categories. Rituals of terminological (re)baptism: Parallelism between exchanges The term “baptism” has long been used to describe the launch of particular referential practices (Kripke 1972:302; Putnam 1975; Silverstein 2004). It is particularly resonant in an argument about the difficulty of maintaining strict boundaries between science, religion, and magic – a difficulty that may paraS C I E N T I Z I N G B A N G L A D E S H I P S Y C H I AT R Y Language in Society 37:1 (2008) 101 doxically provoke still more ritual behavior. That is the crux of psychiatry’s magic complex. Editorial responses in Manabigyān’s advice column are formulaic. From the perspective of “enregisterment,” this entails a form of parallelism emerging intertextually – the successive laying down of grammatically parallel forms. Transcripts 2 and 3 show the Bangla form that rebaptisms of English membership categories take in Manabigyān. They also illustrate another issue that is worth addressing simultaneously: the fact that the editors use a different syntactic construction in characterizing letter writers’ suffering than writers themselves use. The grammatical contrast between x-bhug(‘suffer’) constructions and x-lāg(‘it strikes’) constructions is significant. The psychiatric register associated with baptismal utterances very strongly prefers the former, for reasons explored below, whereas unmarked Bangla discourse tends overwhelmingly to use the latter. (2) Lāge-grammar vs. baptismal discourse in the Advice Column (third issue) 1 āmi kāro sāmne jete bhae pāi. ‘I am afraid to go in front of anyone.’ 2 [āmār] lajjā lāge. ‘Shame strikes me.’ 3 hāt pā kāpte thāke. ‘My limbs just keep shaking.’ Editors’ Reply 4 e asukher nām social phobia. ‘The name of this illness is social phobia.’ In transcript 2 – an exchange with a writer from a peri-urban area of Bangladesh – the responding editors rebaptize the English category “social phobia” 13 in the “water” of the Bangla matrix phrase “tār nām (or in this case, e asukher nām) social phobia.” The more typical baptismal phrase means ‘its name is . . .’. Referential acts form chains, indexing an originary usage. They index participation in the community, in this case cosmopolitan psychiatry, that coopts particular terms for technical use. Note that the letter writer in transcript 2 discloses that lajjā lāge ‘shame strikes’ (with the experiencer left implicit, thus shown in brackets). Transcript 3 highlights the contrast between lāgand bhug-constructions. (3) Lāge-grammar in letter vs. bhugchen in editors’ reply (Letter #25) 1 sab samay sarı̄re ek. tā klānti bhāb thāke. ‘All the time in my body a tired feeling persists.’ 2 [āmār] kono kāj-e-i bhālo lāge nā. ‘No activity makes me feel good’ [literally, ‘In any activity good strikes not.’] Editors’ reply 3 āpni depression bā bi. sannatā roge bhugchen ‘You are suffering from depression or dejection illness.’ Transcript 3 illustrates that the enregisterment of a psychiatric Bangla involves a lexicogrammatical struggle as well as the assertion of parallelism. In J A M E S M . W I L C E 102 Language in Society 37:1 (2008) everyday Bangla, the vast majority of statements indexing feelings make use of lāg‘[it] strikes’ constructions, although that construction can perform a number of tasks beyond expressing inner states. Many things – crowds, flying objects, clothes fitting too tight, nausea, as well as feelings translatable as psychiatric symptoms – can ‘strike’ a person. Letter writers do use lāgconstructions to describe emptiness, shame, fear, and so on. But lāgis used in the letters in all of these constructions, too: man lāgāte ‘applying the mind’; samae lāge ‘time is required’; (in an editor’s reply) āpnār kāje lāgbe ‘it will work for you’; and finally, chariye parte lāgche ‘to begin’. The editors substitute for lāge the bhugchen construction, so consistently as to set up, by means of repetition, a parallelism over time, creating a paradigm, a slot for the things to be ‘suffering from’. This feature of the psychiatric register may – by calquing the English ‘you are suffering from’ – address local psychiatrists’ concern to maintain the respect of the global profession. The editors are responsible for 78% of all uses of the verb bhugin my corpus. By contrast, letter writers use lāgconstructions far more frequently than they use bhug(34 vs. 14 tokens), and are responsible for 71% of all tokens of lāg-. When the psychiatrists use lāg-, they tend to be echoing the writers’ uses. The semantic range of bhugis far narrower than that of lāg-. An anxious young psychiatric profession might feel the need to discipline itself by restricting how it communicates with patients and families about their suffering. A narrower, “purer” verb is better suited than lāgto taking “natural kind” objects (membership categories), clarifying the scientific register, and thereby burnishing the appearance of an increasingly modern national profession. For the psychiatric register, lāgconstructions have the disadvantage of being grammatically impersonal: always third person, never inflected to agree with the experiencer. Things just ‘strike’. Never being inflected so as to be linked to the experiencer, lāgis a very poor candidate for a psychologizing idiom. Although the technical term for cursing someone – bān ‘arrow, black magic’ māre – involves not lāg‘strike’ but mār‘hit’, using bhugdistances psychiatrists from the Bangla semantic network surrounding magic. Finally, lāgalmost never occurs in the progressive form that is so well suited to indexing ongoing subjective states, whereas only 9 out of a total of 64 tokens of bhugare not progressive. To summarize: bhugis always inflected to agree with the experiencer (not an impersonal verb), tightly linked to the experiencing subject. In the psychiatric register it typically occurs in progressive aspect, denoting immediacy and the flux of experience. It is fitted with largely English natural kind objects. (For grammatical details, see endnote 14). By repetition – diachronic parallelism – this forms a slot or paradigm for rebaptized English nosological labels, best seen in Transcript 2, line 4. The baptismal function and the careful attention to form (resulting in diachronic parallelism) index the psychiatrists’ concern that the registral features distance them from magic and religion. The final transcript demonstrates this even more clearly. See Appendix for transcription conventions. S C I E N T I Z I N G B A N G L A D E S H I P S Y C H I AT R Y Language in Society 37:1 (2008) 103 (4) Dr. Pushpu’s interview of Manwara’s family 1 Doc This is your17 daughter [right?]. 2 A year ago,18 she (.2) – one time19 she had (.2) 3 this sort of thing happen to her, right? 4 Back then20 it just21 got better [right?] 5 Doc (.1) 6 Mo ((nods while speaking inaudibly)) 7 Doc Right. 8 At that time what sort of 9 treatment22 did you all provide [her]? 10 Mo 0Well0, 11 Landlord 0Fakirs0 or whatever is what they tried. 12 Doc Yes? 13 Mo 0By means of kabirāj0.23 14 Doc 0Yes024 15 Mo 0we cured her.0 16 ((gestures “And that’s it.”)) 17 Doc 0And0 what else did you pursue? 18 And (.1) you provided kabirāj. 19 What else did you provide? 20 Mo I25 didn’t do anything 0else.0 21 Bro 0Here0, look ((showing the)) 22 ((amulet26 around sister’s neck)) 23 Land They took her to fakirs. 24 Bro She took her to fakirs. 25 [She did] a lot or whatever (1) 26 [She] provided magical sweeping.27 [12 lines deleted] 41 Doc they provided kabirāj 42 And second there was 43 magical sweeping. 44 And notice, the patient’s – 45 here, there’s an amulet – 46 there’s an amulet on the patient’s neck. 47 (1) 48 There was the amulet. 49 And at that time.28 50 ((turning to face patient’s family)) 51 the patient gradually improved.29 52 Right? 53 Afterward, 54 this time when it happened, 55 uh, your, 56 for about the past ten months – 57 this time30 haven’t you31 gone down that line? 32 58 Did you pursue that line? 33 59 Mo 0((nods and speak inaudibly))0 60 Bro Oh, yes. [11 lines deleted] 72 Doc There are these three amulets you see. 73 The second 74 second time this happened or whatever 75 then she was given an amulet [50 lines deleted] 125 For the months you were treating her, 126 Bro [Yes] sir, sir, sir.34 J A M E S M . W I L C E 104 Language in Society 37:1 (2008) 127 Doc along that line.35 128 how much money did you spend? 36 129 Bro (1) It falls to::: four to five thousand 130 Taka 0expense.0 131 Doc 0Four to five0 thousand taka. 132 What, approximately, 133 is your monthly income? 134 Bro My income is 135 monthly two, uh 136 two thousand (1) four hundred Taka. 137 Doc So, actually it’s a substantial portion 138 of [your] funds you spent here.37 139 Bro Yes – I even took out loans. 140 Doc OK 141 OK, this (.2) 142 Before (.2), by amulets and charms 143 the way you38 provided treatment – 144 Bro Mhm 145 Doc The first time she39 improved. 146 This second time (.2), 147 you are pursuing treatment on this line – 148 Bro 0Mhm0 149 Doc 0 – what0 you pursued 150 Bro 0Mhm0 151 Doc And you40 ((looks away from interlocutors)) – 152 Who told you that this 153 ((turning back toward family)) 154 this kind of treatment exists? 155 Land Just some 0village people.0 156 Bro 0This village0 person-doctor. 157 Doc 0No0 to the doctor’s line 158 Bro 0I’ve brought0 159 Doc 0you410’ve brought her. 160 Bro Yes 161 Doc After so long42 you’ve brought her 162 Bro Yes, 0yes.0 163 Doc 0The0 first time you didn’t, 164 the second time you brought her. 165 Bro [Yes,] sir. 166 Doc This, whathat is, wha(.1) – 167 in your mind – 168 wha – , that is, who:: (.1) 169 Doc Did you43 bring her on your own 170 or did other people say something? 171 Bro Others said something. 172 Besides, a doctor’s treatment, 173 we didn’t bring her – for economic, 174 for money reasons. 175 Doc Yes. 176 Bro We don’t have that much money. 177 Doc No, the first, that is, the first time 178 that this happened. 179 Think, not this time, 180 Bro Mhm 181 Doc [but] the previous time it happened. 182 Land 0(inaudible)0 183 Bro 0[Yes] sir, sir.0 S C I E N T I Z I N G B A N G L A D E S H I P S Y C H I AT R Y Language in Society 37:1 (2008) 105 184 Doc At that time didn’t you consider 185 that what she had, 186 there was a doctor’s treatment for it? 187 Mo No, my child, we hadn’t heard that. 188 Doc 0This – 0 189 Land 0Back then0 they hadn’t thought that 0much0. 190 Bro Back then we hadn’t thought that 0much.0 191 Doc That is, it means, 192 [the fact] that this is your [real live] mental illness44 193 you’d never even thought45 that. 194 Land They hadn’t understood46 that much. 195 Doc The second time it happened, that time, 196 how did you come to understand? 197 Land Gradually, 0(inaudible)0 198 Bro 0(inaudible)0 Gradually, imagine47 – 199 It’s not getting better! 200 The money – howe:::ver (.2) much we spend 201 no fruit is coming of it (.2). 202 She’s getting worse day by day. 203 That’s it or whatever. 204 So, we brought her to Dhaka [to you]. 205 Doc But besides that, weren’t there any people 206 you knew. . . Was anyone educated around, 207 that is (.1). . . Who told you this? 208 Land Who told you? 209 Bro Uh, yes, one day [someone] said. 210 Doc Who said? 211 Bro That was Musharaf, 212 Doc 0No, your0 213 Bro 0Musharaf Hussein, 0 a [village] doctor. 214 Doc village who [what role]? 215 Bro [A person] of the village. 216 Doc Of the village. 217 That is, [was he] a pretty wealthy man? [relative to those who are there] 218 Bro Yes 219 Land He said he was a doctor.