The Embodiment of Kintsugi

Anthrodendum welcomes guest blogger Shir Lerman Ginzburg, project director in the Department of Pediatrics and the Preventive Intervention Research Center (PIRC) at the Albert Einstein College of Medicine in the Bronx.  She earned both her PhD in medical anthropology (2016) and her MPH (2015) from the University of Connecticut.  Her primary research interests include mental health (particularly depression and anxiety), idioms of distress, obesity, diabetes, mindfulness, Hispanics, and Puerto Rican identity.  She also has an interest in the Zika Virus and health disparities.

The Embodiment of Kintsugi

Shir Lerman Ginzburg

 

Kintsugi

When I was in graduate school and exploring how to frame my research on mental illness, I stumbled across the Japanese art of Kintsugi, which involves the repairing of broken pottery with gold or silver lacquer, and treats the pottery’s breakage lines as part of the history of the object, rather than a flaw needing to be disguised.  Kintsugi hovered at the edges of my memory as I conducted my research and subconsciously guided my understanding of the healing process from depression.  I came to embody the practice of Kintsugi as a personal practice, which in turn helped me acknowledge and share my personal experiences with depression.

 

Introduction

My relationship with depression began before I was born.

My paternal grandmother, a Holocaust survivor, suffered from depression as a result of the horrors she faced; watching her draw on the same courage to battle depression motivated me to study it in graduate school.  I inherited her vulnerability for depression, but it was only when my brother was diagnosed with a benign brain tumor in February 2011, during my first year in my doctoral program, that depression staked a personal claim in me.  Simultaneously researching and suffering from depression while trying to remain upbeat for my brother pushed me to compartmentalize my own experience, borne of my desire to not let my personal life affect my professional life.  I valued my doctoral training very highly and worried that my struggle would impact my ability to complete my degree.  I freely discussed my academic interest in depression with friends and colleagues, but forbore to disclose my own suffering, even going so far as to hide the fact that I was going to therapy, hoping that this silence would mitigate my depression (despite research and ensuing personal experience to the contrary).  This decision only exacerbated my depression, as it left me feeling isolated and prevented me from fully acknowledging the effect that my emotions and mental state had on my academic performance and my personal relationships.  My brother survived, thankfully, but I was left breathless and disoriented in the aftermath.

Puerto Rico

It was therefore in a disjointed frame of mind that I traveled to Puerto Rico in December 2011 to set up a field site for my pilot study the following summer, and it felt almost like a vacation, the warm breeze and tropical flavors a sharp contrast to dreary, wintry Connecticut.  I was there to study depression, diabetes, and obesity syndemics, and during that initial visit, I successfully created contacts with a state-run diabetes clinic on the medical sciences campus of the University of Puerto Rico in San Juan, receiving permission to return the following summer to conduct my pilot study there, pending IRB approval.  When I returned to Puerto Rico in May 2012, obtaining IRB approval wasn’t the only thing to happen since my last visit – my paternal grandfather had passed away unexpectedly in February from pneumonia, leaving me reeling.  I was unable to attend his funeral due to both his geographic distance from me and to the religious immediacy of the funeral after his death; the added guilt of that loss lengthened my emotional recovery process and left me reluctant to collect data.   My research on depression in Puerto Rico began with me already struggling with depression and with the isolation of doing research relatively alone.  I was renting an apartment from a friend of a friend, and while the apartment was spacious and right on the beach, I was also living there alone, which added to my depression.  Making friends proved to be challenging, living as I was in a neighborhood of transitory expats.  Nonetheless, I began my interviews with an emotion that would ripen into enthusiasm, happy as I was to actually begin collecting my own data.  After muddling through four or five interviews during which participants cried while discussing depression, I remembered the box of tissues in my therapist’s office back home and began carrying my own box of tissues with me whenever I conducted interviews in order to be better prepared for contingencies, and I conducted no more than two interviews a day in order to preserve my own mental wellbeing. My adviser later informed me that she had dubbed this plan “ethnographic learning-by-mistake.”  I started going to religious services at a nearby community center and began making friends there with locals, as well as with people in my building, some of whom invited me to a 4th of July party on the roof of our apartment building.  Slowly, I began to stagger out of the fugue state I’d been in for the past four months, and began to stumble along the path towards recovery.

And then the worst-case scenario happened: my other grandfather, my mother’s father, who had been sick with colon cancer, suddenly took a turn for the worse.  A succinct phone call from my mother told me to pack a bag and head to the airport immediately because she had already bought me a plane ticket, but to no avail.  I was en route, my parents and brother were en route, my aunts, uncles, and cousins were en route, but my grandfather passed away while all of us were on our various flights, with only my grandmother by his side.  The shock of it hit me when I arrived, as the guilt at not being able to say goodbye to my other grandfather only five months after losing my first one, made the loss more difficult.  I was able to make it just in time for the funeral and the ensuing period of mourning, but then we all had to return to our various homes.  This grief process was markedly more onerous due to the lack of nearby social support, compared to when my paternal grandfather had died in February.  My parents had each other, my brother had his friends, my cousins had each other, my grandmother had her friends.  I had a circle of acquaintances I didn’t know well enough to trust with discussing themes of personal depression and grief.  The rest of my friends were conducting their own research in Ghana, England, Guadeloupe, Ecuador, Cataluña, New York, and Connecticut, and were not close at hand to provide comfort.  I was no longer in therapy, as I thought myself well enough on the route to recovery in May to not want therapy during fieldwork.  In any case my therapist moved on to other opportunities at the same time that I left for Puerto Rico, leaving me sans therapist and without the desire to get acquainted with a new therapist while in the field.  I steeled myself to spend the remainder of the summer “just dealing with it,” further compartmentalizing my grief.  I sequestered myself within my apartment or at a nearby Starbucks whenever I wasn’t at the clinic, hindering my own research in the process by not exploring San Juan as thoroughly as I ought, which in turn limited my grasp of the social and structural factors in Puerto Rico that underpinned the very syndemic I was there to identify.  It was only when I returned to Puerto Rico in January 2014 for my longer fieldwork that I began to enjoy Puerto Rico more thoroughly and stop subconsciously associating fieldwork with despondency.

Out of the Depths

It was at the time of my maternal grandfather’s death in July 2012 that, desperate for friendly interactions and without the guidance of a therapist, I began to ask for help from others in my life.  Recalling my lack of social support, I mentioned to my friends at home that I had lost my other grandfather and that my depression had relapsed, and suddenly there were flowers arriving at my apartment and concerned phone calls at all hours, asking how I was doing.  I began to suspect that my friends had made an agreement behind my back to not leave me alone for more than an hour at a time.  Soon, I had a busy Skype schedule with friends who wanted to keep me company and make sure I was doing alright.  The help I received both hastened my voyage along the path of recovery and alleviated my own trepidation about discussing depression as a personal illness, as it permitted me a deeper understanding of the ways in which depression affected all aspects of life, including the professional side that I had tried so hard to separate from my personal life.  The experience was utterly unnerving, wholly consumed as I was with the very topic I studied.  It encompassed a complete dismantling of self, an emotional realignment to comprise a startling pendulum of feelings that swung from stark numbness to acute emotion. Depression eradicated all of my preconceived notions of my own abilities to do everything independently, when in fact part of my own journey with depression involved a profound loneliness that was mitigated by the help I initially resisted so tenaciously.

Interviewing others with depression became uniquely personal and sympathetic, providing me with extra sensitivity into the way I asked questions, the stillness with which I listened to my participants’ analyses, and the meanderings we took during interviews whenever participants needed to take a break and discuss other topics.  And sometimes, my participants and I did not complete the full interview guide, instead having in-depth conversations that permitted a deeper discussion of depression as an illness and the effects it had on interpersonal relationships.  My participants framed depression not only as a result of structural inequalities, but also as a consequence of loneliness, breakdowns in personal relationships, and the suffering of loved ones.

Ultimately, I would have done several things differently if given the opportunity.  I would have had a therapist “on call” if needed, given my own vulnerability for depression, and I would have reached out to friends and family much more quickly to ask for help.  “Toughing it out” is dangerous when dealing with mental illness, given the isolation that people with mental illnesses already face.  When I began my fieldwork, I assumed that isolation was part and parcel of the experience, but I didn’t anticipate how overwhelming the loneliness would be.  I admitted my depression to my committee after I returned home, to which they responded, “That’s common – why didn’t you reach out earlier????” The “ask for help” approach to fieldwork was not something I had considered until I was already in need of it, but which is now a guiding force for my current and future ethnographic work.  It also highlights the need for a stronger social support network for graduate students who are in the field, particularly those who organize their own field sites and/or did not have preexisting social networks in place.  While I turned out alright, it could have gone very differently.

My brother’s illness in 2011 and the loss of both grandfathers within a 5-month period in 2012 left me reeling but unwilling to recognize the profound effect that these events had in my life. When I finally began reassembling myself, I wasn’t the same person I was before the depression, but rather mirrored the Kintsugi that I had discovered earlier in graduate school.  My depression is part of my history and is traced through my academic and personal discourses, and ultimately became part of my healing process.