Arthur Kleinman


Overview


Arthur Kleinman is an anthropologist and a psychiatrist at Harvard University. He teaches anthropology, global health and social medicine, and is Harvard’s Asia Center director. Kleinman’s contribution to medical anthropology and psychiatry is immense: he work has helped shape the conception of illness and disease, explored the importance of illness narratives and experiences in anthropology and psychiatry. His influence can be seen through his leadership in multiple national and global health-related spheres and projects, such as the Diagnostic and Statistical Manual of Mental Disorders IV, the Institute of Medicine’s report on suicide prevention, and the World Health Organization’s World Mental Health Report.

Research & Work


kleinman_arthur.jpg
Arthur Kleinman
Kleinman is known for his scholarship in mental health issues in the Far East. Since 1969, Kleinman has studied mental illnesses such as depression, schizophrenia and suicide in Taiwan, China and Hong Kong. From this body of research, Kleinman authored and co-edited publications on mental illness in Chinese societies, including Social origins of distress and disease: depression, neurasthenia, and pain in modern China,[1] and Patients and healers in the context of culture: an exploration of the borderland between anthropology, medicine, and psychiatry,[2] It was from this research Kleinman began his theoretical work on the illness/disease contrast. He demonstrated how mental distress can be expressed physically through his work with Chinese patients.

Kleinman continued to examine the intersections of culture, social construction of illness and biomedicine in his career. He expanded the concepts of interpretive medical anthropology, by viewing illness experience and the biomedical doctor-patient exchanges as symbolic realities.[3] Doctors and patients often navigate different meanings of symptoms and semantic networks, which can result in misunderstandings and poor quality of medical care. In The Illness Narratives: suffering, healing, and the human condition,[4] Kleinman explored the tension and gap between advances in medical technology and the quality of care and illness as experienced by patients. To counter this, Kleinman recommended the use of an explanatory model, a method devised to improve doctor-patient exchanges by helping doctors understand their patient’s experience of illness through narratives.

However, critics argued that Kleinman’s approach to bridge the doctor-patient gap using explanatory models often result in aligning the latter’s views with the doctor’s.[5] There is no true “working alliance” between the two because the practice of medicine assumes that the biomedical perspective trumps all others. Scheper-Hughes raised the question of what happens when both doctor and patient have differing, irreconcilable interests. Other critics argued that the premise of doctors and patients being equals is faulty because of power and political economy dynamics.[6] Singer argued that much of the tension between patients and doctors resulted from class, gender and racial conflicts within society, not because of different conceptions of illness or culture.

In other less clinical realms, Kleinman explored subjectivity and suffering in Social Suffering,[7] a volume that examined consequences of man-made and natural disasters and human responses them. The focus on subjectivity continued in Violence and Subjectivity,[8] which considered how violence shapes subjectivity. In this book, which Kleinman co-edited, contributors analyzed how people live with more subtle and structural violence.

His lifelong scholarship on illness experience, suffering and morality took a more personal turn in recent years. Kleinman’s current project focuses a subject that draws heavily from his experience as a caregiver to his long-time spouse. His wife of 43 years, Joan, was diagnosed with Alzheimer’s disease in 2003, and Kleinman took care of her until her death in 2010. In several newspaper and television interviews, Kleinman spoke at length about grappling with his wife’s illness, his sense of obligation, and his despair at the realization that she would not get better.





Biography


Kleinman was born in New York in 1941. He was married to Joan Kleinman for 43 years, and has two children and four grandchildren.

He received his A.B. and M.D. from Stanford University and his M.A. in anthropology from Harvard. He was also awarded an honorary Doctorate of Science from York University in Canada. He served his medical residency at Harvard Medical School. He has taught psychiatry and anthropology at the University of Washington, National Taiwan University Hospital, and Massachusetts General Hospital. Kleinman also held the title of senior medical anthropologist at the Brigham and Women’s Hospital’s Department of Internal Medicine. He has taught at Harvard since the 1970s.

Being an anthropologist and a psychiatrist has placed Kleinman in a unique position to bridge the gap between medicine and culture, and academia and the health arena. For instance, Kleinman founded the journal Culture, Medicine and Psychiatry in 1976. He helped provide insights on culture and mental disorders during the drafting of the Diagnostic and Statistical Manual of Mental Disorders IV. He helped write the Institute of Medicine’s report on suicide prevention, and the World Health Organization’s World Mental Health Report. Aside from the mental health realm, he has chaired numerous conferences on national and global health issues, ranging from co-chairing a conference on science and ethics and placebo, to avian flu and AIDS stigma. He practiced psychiatry for 25 years, but stopped practicing in 2000.

Kleinman sits on numerous boards of academic journals as well as national and international committees/councils on medical and health issues. He received more than 50 grants and numerous awards and honors in his long career, including the George Foster Practicing Medical Anthropology Award and the Career Achievement Award from the Society for Medical Anthropology, Cleveringa Professor from the University of Leiden in the Netherlands, honorary professor at Fudan University in Shanghai, and the Medical Humanities Excellence Award from the Imperial College London.

Major Publications


Desjarlais, R., Eisenberg, L., Good, B., and Kleinman, A. World Mental Health: Problems and Priorities in Low-Income Countries. Oxford University Press, 1995.

Das, V., Kleinman, K., Ramphele, M., and Reynolds, P. (Eds.) Violence and Subjectivity. University of California Press, 2000.

Kleinman, A. What Really Matters: Living a Moral Life Amidst Uncertainty and Danger. Oxford University Press, 2006.

Kleinman, A., Das, V., and Lock, M. (Eds.) Social Suffering. University of California Press, 1997.

Kleinman, A. Writing at the Margins: Discourse Between Anthropology and Medicine. University of California Press, 1997.

Kleinman, A. The Illness Narratives: Suffering. Healing and the Human Condition. N.Y.: Basic Books, 1988.

Kleinman, A. (1986). Social Origins of Distress and Disease : Depression, Neurasthenia, and Pain in Modern China. Current Anthroplogy, 24(5): 499-509.

Kleinman, A. Patients and Healers in the Context of Culture: An Exploration of the Borderland Between Anthropology, Medicine, and Psychiatry. Berkeley: University of California Press, 1980.

Kleinman, A. (1977). Depression, Somatization and the New Cross-cultural Psychiatry. Social Science & Medicine, 11(1):3-10.

Kleinman, A. (1976). Culture, illness and care: Clinical lessons from anthropologic and cross-cultural research. Annals of Internal Medicine, 88:251-258.

Kleinman, A. Rethinking Psychiatry: From Cultural Category to Personal Experience. Free Press, 1970.

Online Resources


  • Arthur Kleinman's curriculum vitae can be found on Harvard University's Department of Anthropology website as well the Department of Global Health and Social Medicine site.

  • In 2009, Kleinman held a plenary session at Yale University for a Society of Medical Anthropology called Reflections on the Future of Anthropology. The session featured speakers such as Paul Farmer, Didier Fassin and Merrill Singer. Richard Sosa, of Yale, spoke to Kleinman about where the field is headed and considerations for future research.

  • In 2006, Kleinman spoke to a Boston Globe reporter on his book, What Really Matters: Living a Moral Life Amidst Uncertainty and Danger, about his concern on the medical-industrial complex and living an ethical life. In 2010, Kleinman participated in a PBS program called Religion & Ethics Newsweekly, where he talked about his experience as his wife's caregiver.

References


  1. ^ Kleinman, A. 1986 Social Origins of Distress and Disease : Depression, Neurasthenia, and Pain in Modern China. Current Anthroplogy, 24(5): 499-509
  2. ^ Kleinman, A. 1980 Patients and Healers in the Context of Culture: An Exploration of the Borderland Between Anthropology, Medicine, and Psychiatry. Berkeley: University of California Press
  3. ^ Good, B.J., Fischer, M., Willen, S.S., and DelVecchio Good, M., editors. 2010 A Reader in Medical Anthropology: Theoretical Trajectories, Emergent Realities. Wiley-Blackwell
  4. ^ Kleinman, A. 1998 The Illness Narratives: Suffering. Healing and the Human Condition. N.Y.: Basic Books
  5. ^ Scheper-Hughes, Nancy. 1990. “Three Propositions for a Critically Applies Medical Anthropology.” Social Science Medicine 30:189-197
  6. ^ Singer, Merill 1995 “Beyond the Ivory Tower: Critical Praxis in Medical Anthropology.” Medical Anthropology Quarterly 9:80-106.
  7. ^ Kleinman, A., Das, V., and Lock, M. (Eds.) 1997 Social Suffering. University of California Press
  8. ^ Das, V., Kleinman, K., Ramphele, M., and Reynolds, P. (Eds.) 2000 Violence and Subjectivity. University of California Press.