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Mad in America: Rethinking Mental Health

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

Mad in America: Rethinking Mental Health

Mad in America

Anxiety, Mental Health, Benzo, Science, Hearingvoices, Psychology, Antipsychotic, Mentalhealth, Depression, Panicattack, Psychosis, Medicine, Health, Health & Fitness, Psychiatry, Ssri, Antidepressant

4.8201 Ratings

🗓️ 21 May 2025

⏱️ 38 minutes

🧾️ Download transcript

Summary

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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Transcript

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0:00.0

Welcome to the Madden America podcast, your source for science, psychiatry, and social justice.

0:13.7

Hello, everyone. Welcome to Madden America. Our guest for today is Dr. Lawrence Kermere,

0:18.7

who is a prominent Canadian psychiatrist,

0:21.5

known for his pioneering work in the field of cultural psychiatry and indigenous mental health.

0:26.5

He has made significant contributions to understanding how cultural, social, and historical factors

0:32.1

fundamentally shape our experience, including that of mental health and ill health.

0:37.4

As a researcher and clinician,

0:39.5

Dr. Kermere has been particularly focused on studying topics like cultural identity, personhood,

0:45.8

migration, metaphors, and trauma. His work has been instrumental in challenging the conventional

0:52.1

one-size-fits-all approach to psychiatric treatment,

0:56.4

advocating for more personalized care that is fundamentally built upon the cultural context of

1:01.6

individuals. Dr. Kermayor, welcome to Mad at America.

1:05.8

Thank you very much. I'm very glad to be here.

1:08.6

All right. So we will kind of, the first thing we'll talk about is the one concept that goes through

1:14.5

much of your writing, that is culture, right?

1:17.1

And I know that there is this idea we have that we can understand people somehow in isolation

1:22.9

or that we can study culture as an afterthought, as an add-on, right? Or we can isolate it or we can

1:31.7

integrate it, which is absurd as if, you know, in any way we could study people without

1:37.1

their context. And you have, of course, written that we are fundamentally cultural beings.

1:43.3

So could you explain or just describe what you mean by that?

1:47.6

Sure.

1:48.0

I think this is an important perspective to really underscore

...

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