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Orkideh Behrouzan , Prozak Diaries: Psychiatry and Generational Memory in Iran (Stanford, Calif.: Stanford University Press, 2016). Pp. 312. $90.00 cloth. ISBN: 9780804797429

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Orkideh Behrouzan , Prozak Diaries: Psychiatry and Generational Memory in Iran (Stanford, Calif.: Stanford University Press, 2016). Pp. 312. $90.00 cloth. ISBN: 9780804797429

Published online by Cambridge University Press:  26 July 2017

Cyrus Schayegh*
Affiliation:
Department of Near Eastern Studies, Princeton University, Princeton, N.J.; e-mail: schayegh@princeton.edu
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Abstract

Type
Book Review
Copyright
Copyright © Cambridge University Press 2017 

Prozak Diaries, the first monograph of Orkideh Behrouzan, a medical anthropologist with a degree also in medicine, is a significant addition to the literature on modern Iran, particularly in the postrevolutionary period, and, more broadly, to medical anthropology. Behrouzan argues that by the 1990s Iran's 1980–88 war with Iraq as well as general existential pressures from that decade had created “an imperative of destigmatizing mental illness and raising public awareness about mental health. . . . This 1990s paradigm shift . . . was part of a larger story of the marriage between a specific ideological and cultural pretext and a rational appropriation and normalization of biomedical and psychiatric epidemologies and interventional models; hence a new discourse of care for the self” (p. 89). In the 1980s, posttraumatic stress disorder and anxiety disorder diagnoses had risen; thereafter depression came to the fore, treated often with Ritalin and Prozak. Behrouzan does not talk of “depression,” though, but adopts a Persian rendering, depreshen (used in parallel to afsordegi). To Iranians, she argues, depreshen sits astride a wide field of symptoms and behavioral patterns. Further, “who is diagnosed and who gets labeled as depress is as much a sociocultural question as it is a biomedical one” (p. 34).

Various actors helped popularize psychiatry in general, and depreshen in particular, from the 1990s. Policymakers were on board; the government created “war-related categories of identification, such as martyrs (shahid), veterans (razmandeh), disabled veterans (jānbāz), returning POWs (āzādeh), and their respective wives, offspring, and other kin” (p. 53); print media and radio and TV stations were interested; psychiatrists set aside professional qualms and “went popular” in those media outlets; people, primed by the war as well as by postwar life, were very receptive; and from the 2000s public use of the Internet increased ease of access to information. Psychiatry's popularization was a “coproduction of top-down and bottom-up cultural change” (p. 89). Moreover, while starting among the urban middle class, psychiatrized self-care and self-views quickly spread to rural areas and non–middle class actors, too. Indeed, the very use of psychiatric talk helps mark one's belonging to an aspirational, “growing cultural middle class” (p. 11).

Social class then, is not Behrouzan's analytical lens. Rather, generation is; and it also forms a subjective category for Behrouzan's key interlocutors. These are the daheh-ye shasti-hā, the 1980s kids. Referring to people born or raised in the 1980s, that term is a bit fuzzy, if not “contested” (p. 31). What matters more, though, is that in Behrouzan's “interviews, individuals persistently underscore their generational relation to this particular history” of the war-time 1980s. “These generational identities (and their ensuing labels) anchor themselves in the affective memories of childhood” (p. 29). To be sure, mental health issues rooted in the war affect people across all age groups (perhaps even people born after 1988, one may add, for the Iran–Iraq War's psychological effects surely are passed down at least one generation, like World War II for instance). Even so, for the daheh-ye shasti-hā war-time childhood experiences and medicalized reactions are truly key to their “generational identification” (p. 29). Depreshen is not simply individual, individualizing, or isolating. It also constitutes a powerful “collective sense” (p. 149), not so much of trauma—a term Behrouzan avoids—but of “ruptures” triggered by the 1980s war (p. 30).

Moreover, fascinatingly, as individuals and as a generational collective, the daheh-ye shasti-hā “insist on both remembering and medicalizing their memory” of the 1980s and their lives since then (p. 125). Taking Ritalin and Prozak does not mean to shut oneself out, then. The opposite is true. As an interlocutor puts it, medication “helps us get on with our lives against all odds. . . . We don't give in” (p. 117). Behrouzan unpacks that linkage between medicalization and generational memory and identity in what may be her book's key chapters, the fourth, “Depreshen Talk, the Pill, and Psychiatric Subjectivities,” and the fifth, “Material Remains, Cultural Aesthetics, and Generational Forms.” Focusing on how generational memory is formed and maintained, and how a psychiatrized language feeds into that work, Behrouzan expertly analyzes in tandem “the normalization of a diagnostic mode of thought” and “the persistent revival and mobilization of wartime cultural relics” (p. 127). These relics include objects, songs, and videos. Moreover, Behrouzan not only conducts interviews to trace them, but also enters a generation-bound blogosphere, which she calls an “affective space” (p. 134), and considers art, for instance by Golrokh Nafisi or Shohreh Mehran. She also unpacks the broad field of meaning of depreshen and discusses related terms like depress budan (to be depressed), and neologisms like wiki-depia and dep-zadegan, a somewhat ironic term for those afflicted by depression.

In two other chapters, the third and sixth, Behrouzan examines how the development of psychiatry in the postrevolutionary period built on deeper “pedagogical and cultural histories” (p. 39), and how the daheh-ye shasti-hā’s normalization of psychiatric discourse and psycho-pharmaka has affected how they are now raising their own children, respectively. In the third chapter, she shortly gestures to the complex “cultural and religio-affective foundations upon which psychiatry arrived and thrived in Iran” (p. 40), eluding the danger of defining Shiʿism, for instance, as a unified system. Here her focus, however, is the history of psychiatry in Iran since the 1920s. She argues that since then, the approach dominant in Iran was “biomedical (neuro-centered and psychopharmacological),” although “dynamic (psychodynamic, psychoanalytical, psychosocial)” psychiatry was present, too (p. 43). Thus Freud, though known from the 1950s, was not overly influential, and in the early postrevolutionary years even became an intellectual persona non grata, reviled as the embodiment of Western bourgeois sexed-up (im)morality. Although he made a minor comeback by the late 1980s, biomedical approaches preserved their dominance. Certainly by this point Iran was in sync with global trends, a process reinforced by a young generation of psychiatrists returning from graduate school from the United Kingdom, since the late 1980s, and from the United States, since the 1990s. By that time, psychiatry was becoming a prestigious specialization to medical students in Iran proper, too.

Prozak Diaries contributes to multiple scholarly fields. Behrouzan explicitly transcends “overly politicized analyses of Iranian youth or historical periods” (p. 29). Highlighting the limitations of “top-down formulations of medicalization,” she demonstrates how important popular sociocultural reception is to whether and how biomedicine spreads (p. 35). She adds key insights to our understanding of the history of biomedical sciences in Iran. And perhaps most important, she adds to the literature on generational studies by exploring the intersection between biomedicine and generationally coded identity practices and discourses, including the importance of true ruptures—other scholars may call them trauma—in that complex sociocultural process.

Behrouzan's account could have been even more powerful if she would have made clearer how the work of others form a basis for her views on biomedicine, war, generational formations, and memory. There is, after all, a large body of literature on those topics. She certainly included many texts in her endnotes and bibliography, but only rarely (one exception being this reviewer's monograph) details how those texts have laid the groundwork for her own admirable oeuvre. Furthermore, this reviewer would have loved to hear more about regional and global contexts. This might not have majorly altered Behrouzan's analysis, but it certainly would have added to its complexity—especially because some of her interviewees live outside Iran, which likely affects their generational remembering of the war, and some of the psychiatrists Behrouzan discusses were trained abroad. She notes such contexts (e.g., pp. 51, 53, 88–89, 213–14) but does not integrate them into her analysis. I also would have loved to hear a bit more about how Iran's postwar climate helped enroot depreshen. And a note on political economy would have added to the power of Behrouzan's account. This would include questions such as: Where are drugs produced? In Iran and/or abroad? How much do they cost? How are they subsidized by the state, for whom, at what cost? Who can afford them? And why did policymakers in the 1990s deem it wise to support the popularization of talk about their very own population being depressed?

To conclude, Prozak Diaries is both a fascinating read and a major contribution to our understanding of postrevolutionary Iran and of intersecting fields including trauma studies, generation studies, and medical anthropology. It will be a very valuable addition to both undergraduate and graduate courses on these topics.