Mad in America: Rethinking Mental Health – Details, episodes & analysis

Laurence Kirmayer is one of the most influential figures in cultural psychiatry today. A psychiatrist, researcher, and theorist, he serves as James McGill Professor and Director of the Division of Social and Transcultural Psychiatry at McGill University and Editor-in-Chief of Transcultural Psychiatry. Across decades of work bridging anthropology, psychiatry, and cognitive science, Kirmayer has advanced a complex view of mental health as inseparable from culture, history, language, and political power.

His research ranges from Indigenous youth resilience and narrative medicine to the diagnostic metaphors—such as “chemical imbalance” or “trauma”—that reshape identity and possibility. He has helped pioneer integrative approaches that unite phenomenology and neuroscience, including a biopsychosocial model grounded in enactive and embodied cognition, as well as a person-centered, ecosocial framework for understanding suffering beyond reductive biological paradigms. His critiques extend to how psychiatric categories reflect colonial histories and obscure social causes, as well as how attempts to localize mental health interventions may still impose Western norms.

Kirmayer’s scholarship on narrative, metaphor, and cultural psychiatry aligns with ongoing efforts by Indigenous psychologists and anthropologists to reframe trauma and healing through culturally grounded practices, as reflected in recent collaborative work calling for a decolonial turn in psychology. Drawing on 4E cognitive science, he proposes that metaphors are not simply rhetorical tools but embodied and enacted processes embedded in local social worlds. These shape how people experience distress and how clinicians make sense of it.

His forthcoming book, Healing and the Invention of Metaphor: Toward a Poetics of Illness Experience (Cambridge University Press, July 2025), extends these themes by exploring how metaphor, narrative, and imagination shape suffering and healing across cultures, while offering a critical account of the symbolic and political frameworks embedded in contemporary psychiatric and biomedical practice.

In this wide-ranging conversation, Kirmayer explores the politics of diagnostic language, the structural roots of suffering, and the poetic potential of metaphor to disrupt conformity and open new avenues for healing. From the medicalization of culturally normative expressions of distress to the reification of trauma, Kirmayer shows how dominant frameworks can limit imagination, flatten complexity, and displace political realities with individualized solutions. He calls for a psychiatry that listens not only to symptoms but to the metaphors and metaphysics that animate people’s lives.

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Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. https://www.madinamerica.com/donate/

To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850

© Mad in America 2025. Produced by James Moore https://www.jmaudio.org

Hello, my name is Bob Whitaker, and today I have the pleasure of speaking with Kermit Cole. We'll be speaking about a philosophical enterprise that Kermit is now deeply engaged in. That is, broadly speaking, how humor can help in creating a shared experience that is helpful to the healing process. Kermit, in his experiences of being with people in psychotic states, has seen humor as a moment when a connection can be made. In many ways, this project is bringing Kermit back full circle to his work as a film director, early in his professional career.

After dropping out of Oberlin College, he joined a mime troupe that toured the U.S. as well as Italy and Greece, inspired by his interest in humor as well as how connection arises in the spaces between words. One of his first films was a short titled Before Comedy, which is a film performed entirely without words. Another, which he directed in 1994 was titled Living Proof: HIV and the Pursuit of Happiness.

I met Kermit shortly after I published my book Mad in America in 2002. He was working at that time as a Residence Director of what might be called a halfway house in Cambridge called Wellmet. This was for people who had been discharged from or who were avoiding stays in psychiatric hospitals. The house was modeled to a degree after the Soteria Project.

Then in 2012 after I published Anatomy of an Epidemic, Kermit, Louisa Putnam and I transformed my blog site into a web magazine, also called Mad in America. Kermit was the founding editor of the site, and for the first few years, he was something of a one-man band, posting science reviews, blogs and personal stories at a feverish pace. After retiring from that position, he trained in open dialog therapy, and Louisa and Kermit practiced dialogically inspired therapy with clients in New Mexico. Both Louisa and Kermit are Mad in America Board Members.

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A full transcript of this interview can be found here: https://www.madinamerica.com/2025/05/kermit-cole-dialogical-therapy-and-quantum-theory-walk-into-a-bar/ 

Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. https://www.madinamerica.com/donate/

To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850

© Mad in America 2025. Produced by James Moore https://www.jmaudio.org

Brent Dean Robbins is a psychologist, scholar, and all-around thoughtful human whose work has profoundly shaped existential and humanistic psychology.

He is one of those rare thinkers who makes psychology feel alive—not just a collection of theories and data, but a field full of urgent, deeply human questions. He’s a professor of psychology and the director of the Psy.D. in Clinical Psychology program at Point Park University, where he’s helped create one of the most distinctive training programs in the country. He earned his Ph.D. in Clinical Psychology from Duquesne University—home to some of the most beautifully dense phenomenological work you'll ever have to read twice—and is a licensed psychologist in Pennsylvania.

In this two-part conversation, we’ll explore Brent’s career—from his early work critiquing the overmedication of children to his scholarship on metabletics and cultural therapeutics. We’ll also discuss how he’s navigating his current health journey and cancer diagnosis as an existential psychologist and his hopes for the future of the field—how we might reimagine mental health care in ways that embrace the messy, wondrous, irreducible nature of being human.

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Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. https://www.madinamerica.com/donate/

To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850

© Mad in America 2025. Produced by James Moore https://www.jmaudio.org

Elisa Lacerda-Vandenborn is a professor at Werklund School of Education at the University of Calgary, Canada. She is currently part of several national and international research projects examining education in indigenous communities and the decolonization of mental health. Her writings explore alternate ways of understanding human suffering, challenge the dominant psychiatric worldview, and critique the Euro-American understandings of distress and disease.

Her interests include understanding different ideas of self, especially in indigenous communities, and how our ignorance about these differences harms people we say we are healing.

Lacerda-Vandenborn notes that “Psychology is not a very reflective discipline.” This is a conversation about lost indigenous children, psychology’s blind spots, and how we can address these concerns with epistemic humility.

On the Mad in America podcast this week, we hear from Renee Schuls-Jacobson. Renee was a teacher for two decades and she is now an author, artist, advocate and coach. In this interview, we discuss her book Psychiatrized: Waking up After a Decade of Bad Medicine which was released this year.

The book is a beautifully written account of Renee's experiences being prescribed the benzodiazepine clonazepam (Klonopin) for seven years. It talks of her experiences taking the drug as prescribed but perhaps more importantly, also tells of what happened to Renee as she made attempts to withdraw.

In this podcast, we hear from the renowned clinician and researcher Dr. Giovanni Fava. Dr. Fava is a psychiatrist and professor of clinical psychology at the University of Bologna in Italy. He is also a clinical professor of psychiatry at the University at Buffalo School of Medicine and Biomedical Sciences. Since 1992, he has been the editor-in-chief of the peer-reviewed medical journal Psychotherapy and Psychosomatics.

Dr. Fava has authored more than 500 scientific papers and is known for researching the adverse effects of antidepressant drugs. In a 1994 editorial, he argued that many of his fellow psychiatrists were too hesitant to question whether a given psychiatric treatment was more harmful than it was helpful.

He recently released his latest book entitled “Discontinuing Antidepressant Medications” published by Oxford University Press. The book is designed to be a guide for clinicians who want to help patients withdraw from antidepressants.

In this interview, we discuss the new book, approaches to antidepressant cessation and explore some of the concepts including novel psychotherapeutic approaches to withdrawal.

Hans Skott-Myhre is a Professor of Human Services at Kennesaw State University in Kennesaw, Georgia. Over the last 50 years, he has worked within a wide variety of human service settings, including residential homes, community health centers, inpatient psychiatric units, homeless youth shelters, transitional living programs, and prisons. About two decades ago, he transitioned into academia, where he now does research at the intersections of human services, psychology, cultural theory, and literature.

His recently published book titled “Post-Capitalist Subjectivity in Literature and Anti-Psychiatry: Reconceptualizing the Self Beyond Capitalism” explored how we might be different types of people if we didn't live in a capitalist society. The book draws on Marxist and post-Marxist theory and presents a nuanced analysis of antipsychiatrists' professional writings, including Franco Basaglia and R. D. Laing, as well as the work of fiction writers, including Franz Kafka and Gabriel García Márquez. Through this analysis, Skott-Myhre identifies alternative conceptualizations of self and community that take us beyond capitalist subjectivity.

In this podcast, which comes on the heels of reports linking social media use to reduced self-esteem in teen girls, eating-disorders therapist Shira Collings discusses person-centered, socio-culturally aware approaches to dealing with disordered eating and other food-related challenges in youth (and adults).

Shira Collings, M.S., N.C.C., is Mad in America’s Assistant Editor for MIA Continuing Education and the Youth Coordinator for the National Empowerment Center. She received her B.A. in Communication from the University of Pennsylvania and an M.S. in Counseling and Psychology from Troy University.

As a person with lived experience of recovery from diet culture, disordered eating, and trauma, Shira is passionate about supporting others in finding freedom with food, body acceptance, and the ability to be their full, authentic selves and live according to their values. She is an advocate for trauma-informed, person-centered approaches to mental health care.

Helena Hanson is professor and chair of translational social science and health equity and associate director for the center for social medicine at UCLA. As a psychiatrist and anthropologist, she has spent much of her career researching how race, class, gender, and social determinants of health affect psychiatric diagnosis and treatment.

Growing up in 1970's Oakland and Berkeley, California, Hansen witnessed the consequences of deinstitutionalization and mass incarceration policies firsthand. Losing family members to both the prison and mental health systems gave her a personal understanding of the social and structural failures she interrogates in her work today. She also draws on the principles she learned as a participant in AIDS-related activism to mobilize community organizations and champion mutual aid groups in combatting our current mental health crises.

In this interview, Hansen discusses how race and class affect psychiatric diagnoses and subsequent treatment, the moral implications of psychiatric diagnosis, structural competency, and more.

Schizophrenia is a psychiatric diagnosis that carries a heavy social stigma. However, experts have also questioned the validity and utility of the label. In response, some experts and service-user groups have called for different conceptualizations and terms for those experiencing psychotic symptoms.

Doctors Matcheri Keshavan and Raquelle Mesholam-Gately are currently tackling this issue. They recently completed a project in collaboration with the Consumer Advisory Board of Beth Israel Deaconess Medical Center in Boston, MA, examining the benefits and drawbacks of renaming schizophrenia.

Matcheri Keshavan, M.D. is the Stanley Cobb Professor of Psychiatry at Harvard Medical School and Academic Head of Psychiatry and Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center.

Raquelle Mesholam-Gately, Ph.D., is an Assistant Professor of Psychology in the Department of Psychiatry at Harvard Medical School. She is also the director of the Consumer Advisory Board and conducts neuropsychology research in the Psychosis Research Program at the Massachusetts Mental Health Center.

In this interview, they discuss what they learned about the issues surrounding the renaming of schizophrenia in their research with consumers and service users. In particular, they reflect on how this psychiatric diagnosis can impact the therapeutic alliance necessary for effective treatment and the overall quality of life of people diagnosed.