Well-being and the rise of psychotherapy in Uganda

Perspectives on happiness and mental health differ across the world. While some cultures view suffering and unhappiness as inherent, circumstantial aspects of existence, others view any degree of unhappiness as a personal deficiency and an indication of poor health. Westernized perspectives present happiness as an individualized state of being that can be cultivated and sustained through continuous effort. In areas where these western beliefs are prominent, happiness is established as the norm, and as a result, a global trend has emerged where the absence of happiness is increasingly medicalized and pathologized. When deviation from the norm occurs, it spurs individuals to search out medical and psychological interventions.

In “Struggling to be a ‘Happy Self’?: Psychotherapy and the Medicalization of Unhappiness in Uganda,” published in Current Anthropology, Julia Vorhölter examines the extent to which this trend has spread throughout Uganda. Vorhölter expands upon existing anthropological debates about global mental health by analyzing shifting perceptions of happiness and psychotherapy in Uganda. The author asserts that this shift is the result of new developments in psychological practices and increasing awareness of mental health discourses.

“While experiences of suffering or happiness are always, to some extent, individual and subjective, they are shaped by contexts and authoritative voices,” the author writes. “Increasingly these are global voices — after all happiness is now being measured and compared across societies. Ideals of what it means to be happy and how to achieve it travel across contexts, as do interventions targeting suffering.”

Utilizing ethnographic research, the author analyzes how both views of happiness and participation in psychotherapeutic practices differ across Uganda. By conducting interviews with psychologists and employing qualitative data analysis, the author acquires insights into the personal struggles and stressors that prompt people in Uganda to seek professional help. Findings reveal the motivations behind participating in psychotherapy are heavily influenced by region as well as an individual’s age and social class.

The study focuses on two regions of Uganda: Northern Uganda and Kampala, the capital. Both areas have experienced distinct developments in psychotherapy, beginning in the early 2000s. The civil war reached its conclusion after 20 years, and psychological services emerged in rural Northern Uganda to help alleviate complex post-war traumas experienced especially by lower-class people living in the area. While international donors and NGOs provide these services for free and the services have become more organized and more widely accepted over time, critiques remain about whether psychotherapy services offer an adequate approach to assist people who are experiencing ongoing, systemic problems, such as gender-based violence or poverty.

Conversely, upper middle class Kampalans are progressively prioritizing wellness and taking control of their own happiness. As a result, these individuals are using their financial means to seek out private psychology practices to address their concerns about school, relationships, work, and maintaining the expectations associated with living an urban life.

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