"The Dead Which Cannot Be Buried": War, Madness, and Modernity in the Levant, 1896-1982

Abstract

Drawing on a wide variety of archival and primary sources, this dissertation reconstructs the history of ʿAṣfūriyyeh, one of the first modern psychiatric hospitals in the Middle East, as a window into the ways in which modern medicine changed common perceptions and understandings of mental illness as well as the wider socio-political role that ʿAṣfūriyyeh played in the region. The rise and fall of ʿAṣfūriyyeh—from its founding in 1896 until its closure in 1982, in a region marked by significant political upheavals—calls for a revisionist interpretation of the role and impact of the birth of psychiatry in the region. Not only do apologist and post-colonial histories hinder any account of the metamorphoses that such institutions underwent after the age of empire, but they also miss and obscure important discontinuities—notably the erosion of missionary fervor and the increasing role of local agencies (political, social, and professional) in shaping the future and the impact of such endeavors. The dissertation argues that ʿAṣfūriyyeh was the product of collective actions and influences (both local and global). The Hospital owed its existence, survival, and growth to various factors, including an unabated rivalry between foreign powers and among missionaries as well as to local aspirations for medical enlightenment and modernity. ʿAṣfūriyyeh was a project that was embraced rather than rejected by the general population and was reproduced rather than critiqued by the local elite. The dissertation identifies two major departures from the historiography of Western lunatic asylums. In contrast to the European and North American contexts, where policies of deinstitutionalization played a central role in moving the mentally ill from large psychiatric hospitals in the 1960s, it was the Middle East’s changing geopolitical reality and its underlying moral economy that ultimately reconfigured the mental-health-care landscape. First, psychiatric hospitals grew in size in the post-colonial/post-imperial context. Second, the downfall of ʿAṣfūriyyeh—an emphatically non-sectarian institution throughout its history—during the Lebanese Civil War (1975–1990) paradoxically marked the birth of the sectarianization of health care. Finally, the dissertation proposes a new analytical framework to make sense of the afterlife of such institutions.