Prozak Diaries: Psychiatry and Generational Memory in Iran

Prozak Diaries: Psychiatry and Generational Memory in Iran. Orkideh Behrouzan, Palo Alto, CA: Stanford University Press, 2016, 328 pp. 

Orkideh Behrouzan’s Prozak Diaries provides an ethnographically rich and theoretically embedded entry into the ever-shifting post-revolutionary Iranian milieu. The book draws on the experiences and memories of the generation of Iranians born around or after the 1979 Revolution, who survived the Iran–Iraq War and the sociopolitical suppression of the 1980s. Behrouzan relates their struggles to create a sense of selfhood and societal identity. She begins by observing how, since the 1990s, a growing middle class in Iran—whose status is more reliant on higher education than socioeconomic affluence—has appropriated “psychiatric modes of articulation” (p. 11). This appropriation is neither an unimaginative imitation of Western discourses, nor simply a manifestation of the middle-class youth resistance to the state. Rather, Behrouzan explores how “Iranian psychiatry operates” and engenders “the languages and modes of thinking” through which many youngsters “interpret and make life and its complexities intelligible” (p. 2). Their creative deployment of psycho–pharmaceutical and diagnostic discourses, Behrouzan argues, offers new language and cultural forms for the memories of the 1980s that could have otherwise remained unspoken and unintelligible.

The book is enriched by vigorous research and extensive native knowledge. The author belongs to the same social and age group as her interlocutors and shares many of their memories. Thus when one of her interlocutors drifts back to the 1980s and asks whether she believes she is still having nightmares about “the red sirens interrupting barnameh-ye kudak [children’s television program],” Behrouzan responds, “I can” (p. 92). A former student of psychiatry and later a physician, Behrouzan also has an expansive insider knowledge and first-hand experience of the history of psycho–pharmaceutical discourses and practices in Iran and byond. The book traces the journey of the psychiatric epistemologies, languages, and subjectivities to and within the Iranian sociopolitical and historical landscape, and it shows some significant points of distinction between Iranian and Western psychiatry. Behrouzan argues, for example, that among Iranians today, the practice of taking medications like Prozac is less about individual treatment than articulating and making sense of a collective experience. In their “act of living through and within the experiences of psychological distress,” Behrouzan’s interlocutors attempt to live “life as it embodies, in the same breath, loss and joy, pain and pleasure” (p. 15).

The vibrant interaction of this embodied social life, of words and experiences, is interwoven into the structure of the book. The introduction and each of the seven chapters are prefigured by a social character, respectively: “The Anthropologist,” “The Post-Satirist,” “Freud,” “The Counselor,” “The Student,” “The Blogger,” “The Mother,” and “The Medical Intern.” Each character introduces a particular domain of experiences and memories. Together, they choreograph the social life of psychiatric discourses in Iran in a wide range of mediums, including but not limited to satire, poetry, literature, dreams, flashbacks, memory narratives, and blog posts. For example, “The Anthropologist” relates how Behrouzan’s initial observation of the pervasive usage of such words as depreshen compelled her to explore “why we choose them, how we use them, and what cultural forms they generate” (p. 1). Depreshen, as Behrouzan makes clear, is not the Farsi equivalent for the English term depression. Even in a clinical sense, depreshen blurs the lines “between situated depression, collective dysphoria, melancholy, clinical (major) depression, PTSD, anxiety disorder, and what psychologists call ‘learned helpnessness’.” It problematizes global paradigm of mental health,” partly by juxtaposing “a largely individual-focused modern psychiatry … against the backdrop of a very particular social setting and its cultural experience” (p. 27).

The first three chapters provide a history of psychiatry in Iran and its “Pedagogical and Cultural Histories,” from Pahlavi regimes’ (1925–1941 and 1941–1979) modernizing project in seeking to produce an educated class to the present. Psychiatry came to Iran initially through individuals trained in Western universities. Behrouzan elucidates the tension and negotiation between Iranians’ religio–cultural ethos and Western discourses, reflected, for instance, in the views of the prominent ideologue of revolutionary Shi`i thought in the 1970s, Ali Shariati. Shariati was critical of the dominance of “Freudism’s sexuality” (p. 38) in every aspect of modern life. Behrouzan shows that while a view of “psychoanalytical legacies as Western construct” (p. 22) dominated up to the 1980s, since the late 1980s, mental issues have been openly and at times jokingly discussed. The Iran–Iraq War, Behrouzan maintains, did not merely produce “new societal norms” or help mobilize “the Shi’ite ethos of endurance and sacrifice for justice” (p. 22). It also played a significant role in creating concerns for, and discussions about, mental health. Western-imposed economic sanctions further intensified these concerns. The reality of the social trauma and the prevalence of psychological language and “depreshen talk” (p. 158) were evident both in the establishment of the Counseling and Guidance Center at the Imam Khomeini Institute of Research and Education at the Qom Seminary by Ayatollah Mohammad-Taqi Mesbah-Yazdi in 1991 and the center’s advice to Iranians about alleviating their mental problems through stronger connection with God.

As Behrouzan suggests, memories of war do not dissipate with the passing of time. A section titled “Dreaming the War: The Unconscious Life of Memory” testifies to the enduring life of these memories in new contexts. Currently residing in the United States, some of Behrouzan’s interlocutors speak of their nightmares about the “War on the Cities,” the period in the 1980s when Iraq bombed major Iranian cities. Rather than mere flashbacks, these nightmares are a kind of déjà vu. Behrouzan argues that these dreams “fit into a larger collective context of memory.” They “are filled with cultural bits and bytes” and “situated in their waking life” (p. 151). Her interlocutors’ nightmares revive threats of war that targeted their loved ones in Iran, but they also reflect their own sense of displacement and entrapment, triggered by the escalated U.S. hostility against Iranians and a general anti-immigration attitude in the West. This demonstrates how, as an “embodied experience,” the past “flows into the present in waves and tides,” creating “language forms, reflexive practices, cultural productions, and ways of life that include, but are not limited to, depreshen talk” (p. 158).

Behrouzan’s interlocutors express a desire to “squeeze pleasure” in, and “dig every rock to extract some joy” from life (p. 115). This desire is simultaneously a reaction to the ambiance of the 1980s and a reflection of an attitudinal shift. Rather than embracing melancholic sadness as a mystic virtue or an intellectual posture, many now consider it to be a possible sign of depression. The impact of the 1980s lives on in the continuous suffering of the bereaving families, of the disabled and chemically injured, in the predicaments of the exiled, refugees, and migrants, and in their efforts to turn “ruptures into culturally generative spaces of meaning making and … to translate the embodied experience of the past into the present in…ways that are hardly captured by diagnostic labels such as PTSD” (p. 158).

Prozak Diaries makes an invaluable contribution to medical and sociocultural anthropology, as well as scholarship on memory, trauma, and Iran. Behrouzan’s beautiful writing, free from jargon, renders it accessible to both experts and lay educated readers. Reminiscent of Brechtian theater, the writing avoids explosive emotional invocation, enabling stories to immerse in one’s memory, demanding deeper contemplation. Yet as with every work, this, too, has its limitations. Although Behrouzan makes clear that her subjects are young middle- class Iranians, at times the possible life of the “psychiatric vernacular” among less-privileged, less-educated, Iranian youth feels missing.