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Mad in America: Rethinking Mental Health

The Mad in America podcast, hosted by James Moore, examines mental health with a critical eye by speaking with psychologists, psychiatrists and people with lived experience.

When you hear such conversations, you realise that much of what is believed to be settled in mental health is actually up for debate. Is mental health a matter of faulty biology or is there more to it? Are the treatments used in psychiatry helpful or harmful in the long term? Are psychiatric diagnoses reliable? With the help of our guests, we examine these questions and so much more. 

This podcast is part of Mad in America’s mission to serve as a catalyst for rethinking psychiatric care and mental health. We believe that the current drug-based paradigm of care has failed our society and that scientific research, as well as the lived experience of those who have been diagnosed with a psychiatric disorder, calls for profound change. 

On the podcast over the coming weeks, we will have interviews with experts and those with lived experience of the psychiatric system. Thank you for joining us as we discuss the many issues around rethinking mental health around the world.

For more information visit madinamerica.com

 

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  2. The Poetics and Politics of Our Mental Health Metaphors: An Interview with Laurence Kirmayer

The Poetics and Politics of Our Mental Health Metaphors: An Interview with Laurence Kirmayer

May 21, 2025

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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