Send message to Author

Paper short abstract

In Bengaluru, India, second-opinion seeking in psychiatric care illustrates how mistrust of pharmaceuticals, voiced as “davai khate hi jao” (“keep eating medicines”), becomes productive. I argue this mistrust reorganises care and creates space for psychotherapy as an alternative evidentiary regime.

Paper long abstract

In urban, privatised medical settings across South Asia, seeking a “second opinion” is a common care pathway when a diagnosis or treatment plan feels questionable. This paper reads second-opinion seeking as a form of mistrust toward psychiatric aetiologies, diagnoses, and pharmaceutical regimes—and asks what that mistrust makes possible for psychotherapy. During my ethnography of a psychotherapeutic training programme in Bengaluru, I met Bina Rai at a tertiary mental-health hospital OPD. Bina was the mother and primary caregiver of P, a 21-year-old man in significant distress. She meticulously recorded P's treatment. P was diagnosed with depression and prescribed psychotropic medication of various doses by a psychiatrist in Gwalior, a mid-size urban centre in central India. The psychiatrist at the Bengaluru OPD concluded that medication for depression had precipitated into anxiety. After three years of P’s treatment, Bina’s mistrust of medical dependence, articulated as “davai khate hi jao, khate hi jao”, is an epistemic and affective force that opens the possibility for nonmedical sources of care such as psychotherapy. In a context where pharmaceuticalisation is often the first-line treatment and therapy remains stigmatised, this mistrust becomes generative: it reorganises care through second opinions and opens space for an alternative evidentiary regime.