Generational Care: Psychology, Race, and History in South Africa by Stephen Robert McIsaac A dissertation submitted in partial satisfaction of the requirements for the degree of Joint Doctor of Philosophy with the University of California, San Francisco in Medical Anthropology and the Designated Emphasis in Critical Theory in the Graduate Division of the University of California, Berkeley Committee in charge: Professor Lawrence Cohen, Chair Professor Donald Moore Professor Stefania Pandolfo Professor Ian Whitmarsh Professor Irina Paperno Spring 2019 “Generational Care: Psychology, Race, and History in South Africa” © Stephen Robert McIsaac, 2019 Abstract Generational Care: Psychology, Race, and History in South Africa by Stephen Robert McIsaac Joint Doctor of Philosophy in Medical Anthropology with the University of California, San Francisco and the Designated Emphasis in Critical Theory University of California, Berkeley Professor Lawrence Cohen, Chair In contemporary South Africa, spatial segregation, racism, and economic exclusion remain trenchant features of everyday life twenty-five years after the end of apartheid. Based on twenty months of ethnographic research in the township of Khayelitsha and Cape Town more broadly, this dissertation tracks different post-apartheid approaches to mental health care, which attempt to address these ongoing legacies. Through extensive fieldwork at a community-based organization that provides therapeutic support in isiXhosa, I argue that therapeutic practices by black South Africans de-stabilize and experiment with the normative confines of the psychotherapeutic encounter. Rather than treat individual psyches, therapists’ practices are oriented toward the relational space between generations, a political therapeutic driven by the affective force of the therapists’ own history of struggle toward a different future for black youth, who continue to be marked by the legacies of colonialism and apartheid (what I call “generational care” throughout the dissertation). Second, I argue that normative psychology continues to assume a nuclear family configuration as the norm against which all pathology is judged and therapeutic interventions practiced. I suggest this is particularly so for theories of attachment and infant development, which assume that only a particular configuration of the family—biological parents who unconditionally care for a child in the same physical space as them—is productive of “stable” subjects later in life. By following the history of psychiatry in South Africa, narratives of care from mental health professionals working on the Cape Flats, as well as policy and research agendas, I track how discourses of “cultural difference” evade processes of racialization and consequential racisms in normative psychological theories and interventions. I argue that different practical and conceptual therapeutic experiments are necessary, ones that imagine forms of care adequate to the lived afterlives of the settler-colonial project, and particularly ones for those related outside the nuclear family form. 1 Table of Contents List of Figures ii Acknowledgements iii introduction The Clinic of Elsewhere 1 Race, Space, and the Good Family chapter one Who Do You Think the Patient Is? 30 Generational Care as Political Therapeutic chapter two Mad Urban Areas 45 The Racial Politics of South African Psychiatry chapter three When Attachments Fail 63 On Being in Two Places at Once chapter four History as Image 84 Picturing a Collective Subject Through History chapter five It’s Strange When Something Doesn’t End 111 Cyclical Time and the Biopolitics of Psychic Life chapter six Night / Time & Space 135 Spatial Generations of Memory conclusion At the Edge of Which We Wander 155 History in the Present Bibliography 159 i List of Figures Figure 1 Photograph: “Elsewhere.” (2015) 1 Photo taken by author. Figure 2 Map: “South Africa: Black Homelands.” (1986) 3 United States Central Intelligence Agency Map No. 543001 Figure 3 Map: “Contemporary South Africa.” (2019) 5 Designed by the author using Esri Basemaps. Figure 4 Map: “Cape Town.” (2019) 6 Designed using Esri Basemaps with OpenStreetMaps Design Figure 5 Map: “Union of South Africa in 1914.” (2014) 10 Courtesy of Ministry for Culture and Heritage, New Zealand History Figure 6 Map: “Khayelitsha.” (2019) 13 Designed using Esri Basemaps with OpenStreetMaps Design Figure 7 Map: “Transkei.” (1978) 68 United States Central Intelligence Agency Map No. 503097 ii Acknowledgements Ndiyabulela kumntu wonke umdala noncinci ekhayelitsha ngokulinganayo. Ndibhulungu ngokunishiya phambi kokuba sohlukane mandithe enkosi ngo ndicneda ngendawo uhlala nendawo yokufunda. Ndiyabulela usapho lwam etown two, nguNobuntu nakubantwana basekhaya. Ndibulela kuMonwabisi Maqogi noku sapho lwake. Nindinike ekhaya eMzantsi, ekhayelitsha. Ndiyabulela kakhulu. Okusebini ndibulela iziko lasekukhatalelweni—uViwe, uZoliswa, uNobuhle, uNoma. Ndifike ndizofunda ngemental health nangobundlabongela and nonke nandifundisa ukuthi phambi ngokubandazi ngemental health nobundlobongela kufuneka ndiqale ndazie ngosapho nokuba ulinakekelanjani. Kwakhona ndiyabulela kakhulu. I grateful to so many people in Cape Town more broadly, without whose incredibly generosity none of this would have been possible. Thank you to Leslie Swartz, my first contact for this project, who has supported my research in every way he possibly could. I am immensely grateful to have Alison Swartz as a colleague and friend, who has helped and supported me in so many ways. Christopher Colvin, whose own dissertation was a partial inspiration for this research, supported me unconditionally, as well as gave me an institutional home at the University of Cape Town during my fieldwork. I owe so much to Debbie Kaminer, Louise Frenkel, and Tamara Maresky for many conversations, making connections, and believing in the work. Thank you to Sally Swartz, who frequently made space for me at supper, and for her encouragement. I am also so grateful for conversations with and generosity of Kelly Gillespie, Susan Levine, and Zodwa Radebe, particularly in pushing me to rethink what it means to practice anthropology today. To all of my other colleagues in Cape Town whom I cannot name here, thank you: I hope we can continue the conversation. I have never laughed like I did with Ayanda Ganeko, whose friendship means the world. To my late friend, Azime Ngubane, I learned so much from you, ndiyakuthanda, siyakukhumbula. Maya Marshak is one of the most generous and sensitive people I have ever met—in addition to giving me a peaceful home while I was trying to find my footing, she taught me more than she can know about what kindness looks like. I made a great friend in Sandra Prosalendis, who fiercely supported my work. Without the incredible support of Judy Grant, I never would have finished fieldwork. Arnoldo O’Shea reminded me to take a rest, and to him I am grateful. Conversations with Leo Podlashuc, usually over homemade wine, always made me question what I was doing, and certainly made this work better. While I feel uncomfortable with the acknowledgement-spatial fix I have going on right now, Erin Torkelson disrupts that completely. From Berkeley to Cape Town, Erin has taught me so much about South Africa, and I am truly grateful for her friendship. Thank you all. iii I am so grateful to the wonderful scholarly community at Berkeley for nurturing this work in so many different ways. Working with Lawrence Cohen is a lot like reading Mrs. Dalloway: periodically, you are not sure whose consciousness you’ve been given access to, but as you dwell with him in an indeterminate yet expansive space, a different genre of conversation opens up— one much more beautiful and generative than knowing exactly who you were and what you were supposed to being doing all along. The truly remarkable generosity of Donald Moore is unparalleled, and this work is so much better given his immense sensitivity, rigor, and ethics of care. If I am ever lucky enough to have students, if I can give them only a fraction of the care and warmth he did me, it will have been a major feat. I can only liken working with Stefania Pandolfo to being in therapy—after a meeting or two, she has you and your work completely figured out, but choses to privilege the process of long-term dialogical reflection, until you finally realize what she, proleptically, seemed to know all along. Ian Whitmarsh changed the way I think about everything—a gift whose excess is so great, I fear, that it can never be adequately reciprocated (but he wouldn’t have it any other way). Irina Paperno gave me the great honor of reading me as though I were a writer, and her supreme attunement to genre, voice, style, and plot made this piece of writing incredibly better. More broadly at Berkeley, I am so grateful to Nancy Scheper-Hughes, who in many ways brought me here. No one takes the “it takes a village” approach to mentorship more seriously than Vincanne Adams, who has fiercely supported me from the beginning. Cori Hayden always knew exactly what to say, and her presence made the department an energetic, hopeful place. In addition to leading one of the best seminars I have ever taken, Saba Mahmood gave me the most grounded, productive advice on how to write at a time when I couldn’t stomach the thought. As graduate advisor, Karen Nakamura had my back at every step over the past two years, and I am so grateful for her care. Mariane Ferme always had an open door for me, and I am very grateful for our conversations