From Culture and Psychiatry


A History of Madness, Modernity, and War in the Middle East

By Joelle M Abi-Rached

The development of psychiatry in the Middle East, viewed through the history of one of the first modern mental hospitals in the region.





The development of psychiatry in the Middle East, viewed through the history of one of the first modern mental hospitals in the region.

ʿAṣfūriyyeh (formally, the Lebanon Hospital for the Insane) was founded by a Swiss Quaker missionary in 1896, one of the first modern psychiatric hospitals in the Middle East. It closed its doors in 1982, a victim of Lebanon's brutal fifteen-year civil war. In this book, Joelle Abi-Rached uses the rise and fall of ʿAṣfūriyyeh as a lens through which to examine the development of modern psychiatric theory and practice in the region as well as the sociopolitical history of modern Lebanon.

Abi-Rached shows how ʿAṣfūriyyeh's role shifted from a missionary enterprise to a national institution with wide regional influence. She offers a gripping chronicle of patients' and staff members' experiences during the Lebanese civil war and analyzes the hospital's distinctive nonsectarian philosophy. When ʿAṣfūriyyeh closed down, health in general and mental health in particular became more visibly “sectarianized”—monopolized by various religious and political actors. Once hailed for its progressive approach to mental illness and its cosmopolitanism, ʿAṣfūriyyeh became a stigmatizing term, a byword for madness and deviance, ultimately epitomizing a failed project of modernity. Reflecting on the afterlife of this and other medical institutions, especially those affected by war, Abi-Rached calls for a new “ethics of memory,” more attuned to our global yet increasingly fragmented, unstable, and violent present.

ʿAṣfūriyyeh is the first volume in the MIT Press's new Culture and Psychiatry series.


$45.00 X ISBN: 9780262044745 344 pp. | 6 in x 9 in 20 b&w illus.


  • A remarkable, highly original, and elegantly written history of the Lebanon Hospital for the Insane, or ʿAṣfūriyyeh. Joelle Abi-Rached insightfully links the changing fortunes of this Quaker foundation to the history of a society wracked by wars and sectarian conflict. Despite, or perhaps because of its own resolutely nonsectarian character, it ultimately lost its battle to survive, and it now lies in ruins, mute but vivid testimony to the decline and breakdown of both state and society in late twentieth-century Lebanon.

    Andrew Scull

    author of Madness in Civilization: A Cultural History of Insanity from the Bible to Freud, and from the Madhouse to Modern Medicine

  • This beautifully written book, based on impeccable scholarship, is more than a political history of psychiatry in Lebanon through a study of the birth and death of one mental hospital; it will become an indispensable text for those who wish to understand imperialism and its subjects, changing ideas of normality and pathology, and the relations between religious and medical authority, as they played out in the 'modernization' of the Middle East.

    Nikolas Rose

    Professor of Sociology, King's College London, and author of Our Psychiatric Future

  • “In this book, the innovative and meticulous historian Joelle Abi-Rached takes on a topic long taboo in the Middle East: mental illness. Although the book introduces many new insights in this regional context, it also offers a window into the impact of psychiatry and mental illness in other societies uncomfortable with the breadth of such central parts of modern life. This is an important new book for anyone concerned about the relationship of instability and stability in an age of wars and repeated changes.”

    Leila Fawaz

    Issam M. Fares Professor of Lebanese and Eastern Mediterranean Studies, Tufts University