Black Skin, White Coats: Nigerian Psychiatrists, Decolonization, and the Globalization of Psychiatry by Matthew M. Heaton (review)

The colonial asylum has attracted much scholarly attention over the past twenty years. Knitting together Foucauldian critiques of expert authority with Saidian approaches to “colonial knowledge,” these studies have emphasized the ideological ends served by the treatment of mental illness as well as the material constraints that kept imperialist ambitions in check. Matthew M. Heaton offers a new perspective on these issues by asking how Nigerian psychiatrists reckoned with the colonial legacy in the age of decolonization. Drawing to an impressive degree on archives in Ibadan and Kaduna, Heaton charts how these figures negotiated their training in Western institutions and early careers under British rule, then the evolution of medical care under political self-rule and the expanding role of international forces like the World Health Organization. While Heaton is attentive to differences among the figures he discusses, postcolonial psychiatry in his account is defined by a sense of hybridity — a continuing commitment to Western diagnostic categories coexisting with the insistent rejection of racial typologies and eloquent claims for cultural sensitivity. The psychiatrist who features most prominently in the book, Thomas Adeoye Lambo, emerges as an innovator whose signature initiative for the mentally ill in the 1950s and 1960s combined cutting-edge clinical therapies with immersion in village life in the communities near Aro Hospital.

These are stories worth telling, not least, because they contribute to an ongoing reevaluation of the extent to which “colonial knowledge” was really “colonial” at all. The invocation of master concepts like decolonization and globalization, however, raises difficult questions. Heaton argues that the postcolonial and the global emerged simultaneously in Nigerian psychiatry and that they did so through a model of the mind he terms “humanistic universalism.” Paralleling the achievement of political independence, he suggests, the ascendancy of this model marked a triumph and a liberation for Nigerians — above all because it eclipsed the racist and hierarchical assumptions of British ethnopsychiatry. But equating the colonial era with a “primitivist” view and the postcolonial era with a “universalist” view of African mental illness is debatable. Throughout imperial rule in the twentieth century, British officials, missionaries, and human scientists — including W.H.R. Rivers, Bronisław Malinowski, and E.E. Evans-Pritchard, to name a few of the best-known — proclaimed that universal laws of psychology transcended cultural boundaries. In the 1910s and 1920s, they forcefully rejected Lucien Lévy-Bruhl’s theory of a distinctive “primitive mentality” while explaining difference on the basis of cultural relativism rather than biological evolutionism. Universalistic theories of human nature long predated the end of empire and they could serve many different ideological ends — including evolutionist-hierarchical and liberal-reformist programs within the imperial project.

Some of the most interesting parts of the book demonstrate that universalistic and relativistic conceptions of mind interacted in complex ways on both sides of the colonial/postcolonial divide. While the language of “detribalization” — suggesting that tradition-bound Africans risked losing their minds when confronted with the stresses of Western modernity — is rightly seen as a hallmark of British ethnopsychiatry, Lambo likewise believed the rapidity of social change in Africa was causing widespread mental illness. He echoed colonial thinkers, too, in his invocations of a monolithic “African” culture, in his reliance on a Euro-American vocabulary of psychiatry, and in his faith in science as an agent of progress. Heaton might have addressed the implications of this uncomfortable overlap more fully: what does it mean, after all, that colonial ethnocentrism and postcolonial universalism look so similar in many ways? Complicating matters further is that the modernizing zeal of Nigerian psychiatrists sometimes led them to cast a more skeptical eye on non-Western approaches to mental health than their colonial predecessors. In the 1950s, J.C. Carothers, a notoriously racist British ethnopsychiatrist, argued that some mental disorders could be treated most effectively by traditional practitioners; in the 1960s, by contrast, Nigerian psychiatrist Tolani...