Transgressive Care. The Specters of Physicality in Global Mental Health

In mainstream doxa about global mental health, physical and tactile intervention on mental patients, such as corporeal containment, is frequently stigmatized and/or conflated with abusive practices. Nevertheless, in some Afro-Indigenous traditions, such as among the Miskitu of Nicaragua, certain forms of physical containment can be experienced as appropriate care, fostering somatic empathy. This article explores a set of misconceptions and conflations leading to a stigmatization of Miskitu physical containment, unduly associated to emblems of abusive restraint (e.g., straitjackets), and risks of sexual misconduct (2). By acknowledging the legitimacy of these fears, I argue that hauntings of psychiatric abuse must not be superimposed on practices that are superficially similar but substantially different in meaning, outcomes, and ethical implications. Drawing upon an ethnography of tactile care for grisi siknis (spiritual affliction) in Nicaragua, I explore the controversial practice of physically "touching" mental suffering through bodily containment. My aim is twofold: dissipating the false association between psychiatric abuse and any form of tactile mental care, and suggesting a broader reflection on the potentials of tactility for global mental health.