Finding ruh in the forebrain: Mazhar Osman and the emerging Turkish psychiatric discourse

Abstract

This article examines the emergence of modern psychiatric discourse under the culturally Islamic yet radically secular context of the early Turkish republic (1923-1950). To do so, it focuses on the psychiatric publications of Mazhar Osman [Uzman] (1884-1951), the widely acknowledged “father” of modern Turkish psychiatry; and aims to genealogically trace his scientific project of reconceptualizing ruh, an Arabo-Turkish concept that predominantly refers to transcendental soul, rendering it physiologically within the framework of biological-descriptive psychiatry. The article consequently addresses the elusive and multilayered psychiatric language emerged in Turkey as a result of modern psychiatry’s interventions into a field that was previously defined by religion and indigenous traditions. Attempting to contextualize republican psychiatric discourse within the cultural and socio-political circumstances that has produced it, the article sheds light on how the new psychiatric knowledge propagated by Mazhar Osman was formulated in constitutive contradistinction to religious or traditional discourses, explicitly associating them with the Ottoman past and its alleged backwardness, hence reverberating with the Kemalist project of modern Turkish state building. Furthermore, by focusing on the complexities of the Turkish psychiatric language and the contestations it has generated, the article aims to reflect on the ways in which the Turkish psychiatric language was (and presumably still is) haunted by earlier forms of Islamic knowledge and traditions, despite modern psychiatry’s as well as modern secular state’s systematic and authoritative attempts to erase them for good.

Let me start with a basic question that hardly leads anywhere substantial but into a historical–genealogical maze: What does psyche or soul, or put more precisely, our modern-medically articulated concept of psyche around which psy-sciences such as psychiatry and psychology are formulated, stand for? While it is true that tracing the concept back to the ancient Greek and Roman concepts of psyche or anima and later to the Muslim concepts of ruh or nefs is common practice among historians or philosophers, more nuanced explorations keep reminding us of the tectonic impact of modern attempts in reformulating and universalizing the psyche – a process that has been managed over the last two centuries under the guise of psychiatry and psychology, the so-called modern sciences of the soul. ¹ Both disciplines invested their utmost energy into reifying the psyche, a concept that was previously conceptualised primarily in an immaterial or transcendental manner, by turning it into a scientific entity, hence attempting to physiologically, and when failed, clinically configuring its constitution. ² Despite the long and arduous efforts, the connection between the psyche and the brain, a crucial point of departure for modern psy-sciences in their attempts to physiologically pinpoint the psyche, has never got firmly established. ³ These futile attempts to empirically prove or scientifically articulate what the psyche is seem to have opened the door to further contestations and clashes of competing discourses and realities, leaving us with unresolved configurations as well as fluctuating sets of truths about the psyche or soul, as well as the mind, their connections to the brain, selfhood, sexuality and health.

This article focuses on the ways in which this intricate set of modern transformations over the concept of soul or psyche (ruh) have emerged within the culturally Islamic yet radically secular context of the early Republic of Turkey (1923–1950). It thus aims to trace the ways in which the modern scientific, that is, materialised and universalized concept of the psyche, despite continuing to be referred by the Islamic concept of ruh in Turkish that predominantly denotes to the transcendental soul, was (re)articulated and publicly promulgated by and through the emerging Turkish psychiatric language. ⁴ This process was made possible under the early Turkish republican regime and was part and parcel of its biopolitical project of modern secular nation-building. In other words, the article sheds light on how the new psychiatric discourse propagated during the early republic, which was formulated in constitutive contradistinction to religious or traditional discourses on the soul, sanity or insanity reverberated with the Kemalist project of modern state building and participated in the construction of ‘healthy’ secular Turkish subjects and society under the early republican Kemalist regime. ⁵

Here, a brief reminder might be in order: there is no doubt that the Ottoman-Turkish transformation into modernity had started under the Ottoman Empire. ⁶ Revisionist historiography on the Ottoman Empire even traces the emergence of modern governmental structures in the empire back in the late sixteenth and early seventeenth centuries, way before the so-called Western European impact. ⁷ It was nonetheless with the fall of the empire and the establishment of the Turkish nation state, a discourse that upheld European modernity as the proper model to emulate gained further popularity within the Turkish public sphere. This was partially due to the success of the republican regime and its representation of the Ottoman Empire as the ancien régime from which the Turks had finally been liberated. Within this narrative, the Ottoman past inevitably came to represent the backward, Islamic, and Oriental antecedent of a more progressive secularised and Europeanized Turkish nation state. This literally meant severing any historical ties with the Islamic World and its ‘Oriental’ culture, which came to be seen as the essential reason for the fall of the Ottoman Empire. ⁸ The state-run ‘project of modernity’ hence became more radical in republican Turkey, whose founders aimed to adopt European modernity in almost all its features, including a firm secularism (on a par with French laïcité), and a purely Western civil code adopted from the Swiss code. The process was also consolidated by top-down policies of socio-political restructuring known as the republican reforms (cumhuriyet inkilapları), ⁹ further endorsing an already ongoing process of ‘epistemic modernity’, within which the notions of modern, scientific and ‘real’ were systematically defined and reified in contrast to what was now construed as traditional, metaphysical, superstitious and ‘unreal’. ¹⁰

It is within this historical context that this article aims to locate psychiatric publications of Mazhar Osman [Uzman] (1884–1951), the widely acknowledged ‘father’ of modern Turkish psychiatry, ¹¹ and to genealogically trace his scientific project of redefining the psyche along with sanity and insanity during the early republic. In particular, it examines Mazhar Osman’s efforts to secularise the notion of ruh by redefining it in physiological terms and within the scientific language of modern psychiatry. This, according to him, was the only way to debunk and delegitimize traditional or religious practices of healing. Scrutinising this normative and interventionist line of thought, this study attempts to engage with the elusive and multilayered psy-scientific language (consisting of equivocal concepts such as ruh) that emerged in republican Turkey as a result of modern psychiatry’s empirical interventions into a field and vocabulary that was previously defined by religion and indigenous traditions.

This is also an attempt to put Mazhar Osman under scrutiny as a translator and disseminator of modern psy-scientific discourses originating in Western and/or Central Europe within early republican Turkey. By translation, I do not mean a word-for-word rendition into another language, but a transformation or conversion that involves a dynamic process of cross-constitutive interpretations and appropriations between different socio-cultural and political contexts. ¹² An emphasis on conversion is particularly relevant here since the translation process the article aims to put under scrutiny categorically involves a process of conversion from immaterial to material, subjective to objective and religious to secular. ¹³ One could further add from the empire to the republic into this list of conversions, which I argue, also echoed in Mazhar Osman’s psychiatric discourse. The article consequently engages with an investigation of the composite effects of psy-scientific translations and forms of knowledge as well as truth claims that were disseminated through them. It ponders on the new conditions, categories as well as contestations generated by these novel forms of knowledge, and intents to reflect on the historically contingent (that is to say, not trans-historical or universal) nature of psy-scientific definitions.

A related question concerns the structural amalgamation of these new psy-scientific definitions with social technics and policies of modern governance. ¹⁴ Tracing the processes of translating novel psy-scientific concepts and discourses into Turkish, this study does not approach these processes simply as undulating effects of emerging Western psy-scientific discourses, but pays particular attention to problem-spaces and conditions of possibilities available in Turkey at that moment in time and from within which these scientific discourses came to unfold. Doing so also includes inquiring the ways in which older forms of knowledge permeated into or came to haunt later forms of scientific knowledge and the kinds of people whom the scientific discourse (in alignment with the Kemalist regime) claimed to liberate from the irrationalities of the past.

The article follows in the footsteps of the recent literature that engages with the mutually constitutive relations between Western psy-scientific practices and Islamic healing traditions in the Middle East. ¹⁵ It nonetheless diverges from these studies due to differences in the radically secular context of the early Turkish republic within which, unlike in other Middle Eastern cases, an open relationship between Islamic and secular approaches or definitions could hardly be sustained. The study, therefore, aims to contribute to this literature by bringing in examples of hitherto overlooked forms of mutually constitutive relations between Islam and modern psy-sciences that were shaped under a stringent regime of secularism and could be scrutinised by focusing on the systematic (stately supported) negations of pre-existing Islamic traditions. By engaging with such questions, the study also aims to expand the literature on the emergence of modern Turkish psychiatry, which approaches the subject mainly within a developmental framework of social or institutional history, hence eschew an analytical examination of the Turkish psychiatric language, its composite and contingent relations with Islamic traditions as well as the socio-political dynamics of the early republic. ¹⁶

The article develops in four sections. The first section briefly provides a biographical background for Mazhar Osman, situating him and his psychiatric knowledge production within the first half of the twentieth-century global psychiatry as well as the socio-cultural and political history of early republican Turkey. The closely knitted second and third sections aim to engage with the modern psychiatric discourse Mazhar Osman produced and disseminated to the Turkish public. Among them, the second tackles Mazhar Osman’s attempts to define psychiatry as a physical and clinical field. The third revisits the conceptual history of psyche or soul, with a specific focus on Islamic concepts such as ruh, akıl, kalp and their transcendental connotations, followed by a discursive examination of Mazhar Osman’s psychiatric attempts in reconceptualizing the ruh in a physiological manner. A final section in return focuses on a patient case published by Mazhar Osman to infiltrate further into the layers and complexities of the Turkish psychiatric language. By doing so, the article attempts to provide an analytical ground for seeing through the clashes of realities, experiences and diagnoses that the Turkish psychiatric language has generated, while simultaneously recognising the ways in which this language was (and presumably still is) haunted by earlier forms of knowledge such as Islam and Islamic traditions despite modern psychiatry’s as well as modern secular state’s systematic and authoritative attempts to erase them for good.

Mazhar Osman, psychiatry and nation-building

Before going further, a brief biography of Mazhar Osman, which would situate him within the early republican project of modern (biopolitical) secular state building as well as transnational psychiatry of the period is in order. Mazhar Osman was born into a newly emerging Ottoman middle-class family in 1884. He studied medicine at the Imperial School of Medicine (Mekteb-i Tıbbiye-i Şahane) in Istanbul and, after graduating in 1904, went to Germany to pursue his studies in psychiatry and neurology with some of the foremost thinkers and practitioners in German psychiatry and neurology at the time. Among them were Emil Kraepelin, Theodor Ziehen, Alois Alzheimer and Walter Spielmeyer. ¹⁷ He was trained in descriptive-biological psychiatry, which then treated mental disorders as brain and nervous system diseases, focusing primarily on observable symptoms and behavioural phenomena to identify and classify mental disorders. ¹⁸ Psychiatry in this period and in the hands of descriptive psychiatrists was going through a process of undermining its previous clear-cut (alienist) distinctions between the pathological and the healthy, redefining the overall human population on a scale from normal to abnormal, and promoting itself as a branch of medicine practiced not simply within the isolated walls of asylums but in modern medical psychiatric institutions open to the public gaze. ¹⁹

As a psychiatrist, Mazhar Osman held various governmental positions in the late Ottoman Empire in which modern psychiatry was beginning to be introduced and attempted to be facilitated throughout projects such as the establishment of Toptaşı Asylum in 1873 by the Lombardian physician Luigi Mongeri (1815–1882). ²⁰ Mazhar Osman’s governmental positions during the empire included a professorship of psychiatry at the Imperial School of Medicine as well as the head physician position at Toptaşı Asylum. But his career would fully bloom after the establishment of the republic in 1923. Accordingly, between 1924 and 1927, with the support of the new republican government, he masterminded and managed the transformation of the (Ottoman) Toptaşı Asylum into the first (and still the major) modern psychiatric hospital in Turkey, namely Bakırköy Psychiatric Hospital, which would provide the latest modern forms of psychiatric care and services in the country. ²¹ Turning into a towering figure in the early republic, and one of its leading medical experts, Mazhar Osman also came to be known for his overt promotion of bourgeois family norms – in accord with the modern ‘civil projects’ of the early Turkish republic. He was, at the same time, very prolific in terms of publications, leaving more than a dozen scientific and popular books and numerous articles mainly published in medical journals, many of which were edited by him. ²²

Mazhar Osman’s unrivalled career under the republic would be better understood when one notes that despite being acknowledged as ‘the father of Turkish psychiatry’, he was not the first Ottoman-Turkish psychiatrist to practice and teach psychiatry in the Ottoman Empire. His appointment to Toptaşı Asylum to transform it into the modern Bakırköy Psychiatric Hospital right after the establishment of the republic with the full support of the new regime seems to represent the policy as well as strategies of the republican government in selecting its own experts and authorities. The appointment also sheds light on the process of disposing an earlier generation of experts mainly associated with the Ottoman Empire such as the pioneering psychiatrist Raşid Tahsin [Tuğsavul] (1870–1936), who after graduating from the Imperial School of Medicine in 1892, that is, 12 years before Mazhar Osman, went to Germany to specialise in neuropsychiatry. Returning to the empire, Raşid Tahsin became the first professor to teach psychiatry at the Imperial School of Medicine, wherein Mazhar Osman was among his students. ²³ Over the years, the two would turn into major adversaries, first Raşid Tahsin becoming the main obstacle for Mazhar Osman’s career to fully bloom under the Ottoman Empire, and later Mazhar Osman’s rising career eclipsing Raşid Tahsin’s practice as well as legacy under the republic. ²⁴ Not surprisingly, in 1933 when Raşid Tahsin was dismissed from the Medical School of the University of Istanbul (the former Imperial School of Medicine) due to the republican government’s university reform, his chair was given to Mazhar Osman.

To readers well-versed in the history of Western psychiatry, Mazhar Osman’s career is reminiscent of those of a number of Western psychiatrists and neurologists, such as Emil Kraepelin, Jean-Martin Charcot, Joseph Babinski and others, who were also producing and disseminating modern knowledge on mental issues through their publications, public lectures and the clinics they ran. These clinics were open to the public and aimed to promote modern psychiatry to the wider population while at the same time training new professionals in the field. Similar to such figures of Western psychiatry, Mazhar Osman too had started his own public lectures, called the Şişli Müsamereleri (Şişli Shows) at La Paix Hospital in Istanbul during World War I, which he continued to give until the end of his career. His choice of the word show (müsamere) rather than lecture (ders) to refer to these events clarifies that they were not intended only for experts or students of medicine but a wider general public. These lecture-shows were also supported by Mazhar Osman’s popular publications on psychiatry and mental hygiene, which he continued to produce almost to the end of his life. Moreover, Mazhar Osman’s policies of opening Bakırköy Psychiatric Hospital to the public gaze through various publications and newspaper columns as well as cartoons (such as those that turned the blue bus of the institution into a public mascot) should also be read within the project of disseminating and popularising modern psychiatric discourse among the Turkish public. ²⁵

The point I want to emphasise here, however, is not how Mazhar Osman followed in the footsteps of eminent Western psychiatrists, but rather his role as a public intellectual as well as a state expert of early Turkish republic assigned to raise awareness on mental health and modern medicine. Mazhar Osman accordingly not only produced knowledge that localised the European field of psychiatry but also lectured and wrote on many other socio-cultural and political issues, including nationalism, hygiene (public health), eugenics, civilization, history, science and the military during a time of transition from the Ottoman Empire to the Turkish Republic, emerging as an active (medical) spokesman for the Kemalist state building project. ²⁶ His expertise became such a cultural phenomenon generating popular dictums as ‘tam Mazhar Osmanlık’ (a case for Mazhar Osman) or ‘gidip Mazhar Osman’a görünsene’ (go get your head examined by Mazhar Osman) that remained in circulation in Turkey 30–40 years after his death. ²⁷

In tune with the Turkish Republican discourse that defined the republic as a jubilant and laudatory (i.e., liberating, emancipatory and progressive) break from the Ottoman Empire, Mazhar Osman, employed a language of progress that was premised on the idea of a necessary break from the past. He was therefore fully content for abandoning what he called the ‘inglorious past’, of an ‘impotent Ottoman Empire’ that brought more ‘shame’ than glory to its people, and replacing it with the Turkish republic, which ‘made the Turkish people proud to be Turks’. ²⁸ This is not a surprising positioning for the elites of the newly established Turkish Republic, not mourning the loss of the empire, but celebrating the emergence of the new modern nation state. ²⁹ But what is important to notice here is the way in which this appropriation of the new regime was reflected on and aligned with Mazhar Osman’s psychiatric discourse, overlapping the Ottoman past with ineffective traditional healing, and the Turkish republic with modern psychiatry and its effective scientific methods.

Mazhar Osman’s ideas and projections as a modernizer on how a modern (healthy) society should operate, turning him into a spokesman of the state on such issues, must thus be considered within the context of modern republican state building and the early republic’s consequent biopolitical and secularist policies as well as its national history writing projects. ³⁰ Following this line of thought, the rest of the article will scrutinise Mazhar Osman’s psychiatric project of materialising ruh and conceptualising its disorders as purely biological and physiological sicknesses, as well as his claim that these sicknesses could be treated and cured only by proper and proven scientific methods, in contrast to non-rational, hence unreliable, healing practices of the past.

Psychiatry: a ‘physical and clinical’ discipline

What we witness through Mazhar Osman’s writings is the paradigmatic shift of the understanding and experience of madness from a religious (spiritual or transcendental) domain to a medical (physical) one. Within the analytic framework of the modern psychiatric discourse, the psyche appears as physical, material and concrete, and all mental states and illnesses are explained physiologically and through scientific reasoning. Concurrent with this, Mazhar Osman considered religious healers as his ‘major adversaries’, relentlessly rebuking them for causing more harm than good to the sick. ³¹ He repeatedly harped on the dangers of excluding madness from other physical illnesses and for considering mental issues not as physical problems but as ‘the work of spirits, jinns, demons, guarding angels and enraged gods’. ³² Doing so axiomatically relegated cures to priests and hodjas or to a transcendental realm that defies explanation (of causes) and observation. ³³ He presented case after case in support of his argument. A good example among the many he offered is the case of Mehmet Ağa, who had made the mistake of going to a hodja in search of a cure for his psychiatric problems. His condition deteriorated during this process. Obsessed with the idea that he was now bewitched by the hodja himself, and thus suffering even more, Mehmet Ağa ended up stabbing the poor man. Luckily, the knife was blunt, and the hodja survived. Following this incident, Mehmet Ağa was put into Bakırköy Psychiatric Hospital, where he fully recovered under the treatment of Mazhar Osman. ³⁴ Religious healers and nonscientific psychic healing practices posed a real danger to psychiatry precisely because they continued to haunt contemporary perceptions of the early Republic, making ‘the hodjas and priests far more popular than doctors, and relegating cures to prayers, magic waters and enchanted shirts rather than medication, serums and vaccines’. ³⁵

Mazhar Osman’s goal was to propagate the idea that madness was ‘a physical sickness, just like pneumonia, icterus and appendicitis’, describing it simply as a ‘dysfunction of the cells in the brain cortex, particularly the ones in the forebrain’. ³⁶ It could only be cured by doctors and through medication and ‘not by sacred offerings, prayers or spells’. ³⁷ Just as ‘planes do not fly with prayer, [and] ships do not navigate by magic’ he added, diseases including mental ones could not be cured by superstition but only through medical science, since science was ‘the one and only thing that rules the world’. ³⁸

In all his popular writings, Mazhar Osman underscored the importance of introducing the new language of science to the public as a way of disabling the older language of healing. This included the replacement of older popular terms like ‘jinn’, ‘healer’ and ‘hodja’ with new concepts like ‘psychiatry’, ‘clinic’ and ‘laboratory’, assuring the public that unlike older methods and superstitious beliefs ‘science posed no harm;’ instead, it conquered ‘ignorance and disease’. ³⁹ He further invited young doctors to disseminate modern psychiatry. If they would be successful in educating the masses on the benefits of modern medicine, then they could overcome their ‘biggest adversaries’, that is ‘ignorance, and the religious healers who are the by-products of ignorance’, hence serve to ‘tie the public to the [republican] government, and popularise the new regime among the masses’, ensuring that ‘the population would grow, be healthy, and embrace the [republican] reforms’. ⁴⁰ Following such statements, it becomes hard to decide when Mazhar Osman was talking as a psychiatrist committed to his own medical discipline, and when acting as a republican elite or expert at the service of the Kemalist Turkish state, working to promote and solidify its secular and biopolitical reform projects, ultimately shedding light on the amalgamation of these roles and projects in the early Turkish republic.

Here readers familiar with French colonial psychiatry might find some reverberations between the (racist) anti-Islamic discourse of French colonial psychiatry and Mazhar Osman’s attack on religion as the main obstacle against modern psychiatry in Turkey. Such an approach nonetheless would be misleading not simply because Mazhar Osman was trained in German psychiatry and hence distant to French psychiatry but because he would consider the Turkish Republic as a nation state emerged out of an anticolonial national struggle against post-World War I occupiers and identify himself a Turkish secular Muslim man. This was the prevalent form of identity among the early republican elites, attuned with republican regime’s socio-political claims as well as the national identity it aspired to cultivate among its citizens. ⁴¹ It is also important to elucidate that Mazhar Osman referred not only to German psychiatrists such as Emil Kraepelin, Oswald Bumke, Wilhelm Weygandt, among others in his publications, but also to numerous French psychiatrists, including, but not limited to, Emmanuel Régis, Joseph Rogues de Fursac and Jules Séglas. ⁴² Yet what cannot be found in his publications are references to any studies that were associated with French colonial psychiatry. ⁴³ Mazhar Osman seemed to intentionally refrain from any possibility of translating and/or disseminating the French colonial anti-Islamic and anti-Muslim discourse prevalent in psychiatric works such as Antoine Porot’s Notes de psychiatrie musulmane (1918) and Maurice Boigley’s Étude psychologique sur l’Islam (1908).

Soul (ruh), mind (akıl) and brain (dimağ)

But how did Mazhar Osman deal with the older concepts of soul (ruh) and intellect or mind (akıl), which prevailed and are still used interchangeably in Turkish psychiatric terminology? In this section, I will first look briefly into conceptual histories of interconnected Islamic concepts such as ruh, akıl and kalp (heart). Then, I will address the categorical shift in Western psychiatry from the immaterial soul into the materialised psyche, a shift made possible by inserting the mind and its alleged physical organ, the brain into its language. Finally, I will delve deeper into Mazhar Osman’s attempt to rearticulate a scientific concept of ruh in Turkish, replacing its earlier transcendental understanding with a purely material or physical one.

It is clear that until the emergence of modern psychiatric discourse, concepts such as the soul (ruh, nefs), intellect or mind (akıl) and heart (kalp) remained imprecise and ‘unordered’, precisely because their meanings transpired by and through a network of relations with one another, rendering their ambiguity and profundity as entities in themselves. Within Islamic tradition, the soul or spirit (ruh) is mostly defined through, what Islamic scholar Ebrahim Moosa calls a ‘pectoral psychology’ that designates the chest or pectoral region of the human body as its core. ⁴⁴ In accordance with that, the heart (kalp) emerges as the seat of emotions and conscience and thus, by implication, is inseparable from intellect and reasoning (akıl). ⁴⁵ Some major medieval Muslim thinkers such as Ibn Sina (980–1037), however, in tune with Galenic medicine, acknowledged the brain (dimağ) as the seat of cognition and perception, a framework that conflated the brain and the heart in their respective functions. ⁴⁶ Others like al-Ghazali (d. 1111), influenced by Sufism, despite acknowledging the brain as a cognitive and sensory organ, associated conscience, the utmost intellect, more with the heart than the brain. With a specific reference to the anatomy of the heart, al-Ghazali, for instance, pointed to the existence of a hollowed cavity with dark blood inside the heart that he considered to be the locus of the soul and spirit (ruh), in which the ‘three vital capacities of a human being coalesce: the ability to perceive, the capacity to know, and the capacity to experience things’. ⁴⁷ Within this framework, even though the brain (dimağ) was considered to be part and parcel of the sensory apparatus, the heart emerges as the seat or centre of the overarching apparatus of perception, knowledge and experience. The heart, as al-Ghazali put it, embodied the ‘perfect eye’, or the ‘rational faculty’, the ‘spirit’ and the ‘soul’, all reified through the heart as their nexus constituting a ‘delta into which various tributaries from the intellect, the spirit and the soul flow’. ⁴⁸ In this light, madness (junun) appeared to be located more in the heart than in the brain, making pre-modern cases of madness, such as divine madness (the holy fool), spirit-possession and other forms, to be conceptualised within the complicated network of the soul, the spirit and the intellect, culminating in the heart. ⁴⁹

Allow me to emphasise that my aim here is not to produce a full-fledged historical or genealogical examination of Islamic concepts such as ruh, akıl, dimağ or kalp and their relations to madness or health but to reflect on the ‘unordered’ contours that these concepts had before the emergence of the systemic categorizations and ineluctable authority of modern psy-sciences, particularly psychiatry. Nor do I tend to depict such Islamic concepts as constant or monolithic. Instead, I intend to demonstrate that differing from these Islamic definitions, which locate madness within a polyvocal network centred in the heart, modern Turkish psychiatry focuses exclusively and systematically on the mind and its physical organ the brain (dimağ, beyin) as the site of mental disorders. ⁵⁰ The brain is accordingly defined as an insulated organ that can be studied, observed, dissected and reduced to neurons.

Concurrent with this emphasis on brain prevalent in modern Turkish psychiatry, when one looks into the history of (Western) psy-sciences over the last two centuries, s/he would encounter an account of how the soul or psyche came to be defined through the modern concept of mind under the emerging disciplines of psychology and psychiatry. The soul during this period was systematically transformed from its more immaterial or transcendental grounding into a material or physical one, in which it came to represent the totality of the human mind as well as new categorical concerns such as behaviour, learning, motivation, emotion. ⁵¹ This was a complex process, embedded not only within the course of psy-scientific professionalisation but also in synchronisation and association with the emergence of the modern state as well as the process of secularisation in the West. ⁵² In the case of France, for example, psychiatry’s claims to truth and power were tied to its pursuit of secular and anticlerical goals, reverberating with Mazhar Osman’s antireligious sentiments above, and reflecting on the similarities between the secularist ardour and socio-political premises in France and Turkey. ⁵³ The process further involved materialisation or empiricization of the psyche, a peculiar course facing challenges on various grounds particularly due to the failure of the psy-sciences (particularly including neuropsychiatry) to provide physical evidence over the psyche or mind, which in turn set the standard for connecting and evaluating the mind through memory, either stored consciously or oppressed and hidden in the unconscious. ⁵⁴

Memory in this period, as Ian Hacking puts it, ‘became a scientific key to the soul, so that by investigating memory (to find out its facts) one would conquer the spiritual domain of the soul and replace it by a surrogate, a knowledge about memory’. ⁵⁵ This conceptualization was framed under modern biopolitics and its vision of the ‘human’ as an object of study with a psyche or mind and a memory that can be empirically examined. Psychiatry and psychology, within this context, emerged as the sciences of the human mind, objectively studying the human psyche or soul through memory, thus turning the impossibility of the ‘science of the soul’ into an empirical possibility, the ‘science of memory’. ⁵⁶

This shift from soul to mind in the Turkish case however seems to have a complicated genealogy, at least linguistically, particularly since the Islamic concept of ruh remained (and still remains – albeit ambiguously) in use in modern Turkish psychiatric terminology. The current dictionary of the Turkish Language Association describes ruh as the ‘condition of being alive’, and ‘an eternal entity distinct from somatic body and its limitations’. ⁵⁷ The same dictionary, only as the last possible meaning of the word (and marking it as the scientific definition), delineates ruh as the ‘totality of life, particularly of emotions and drives, directly linked to the organism’. ⁵⁸

Here some might claim a similarity with the use of concept of psyche in the West. This nevertheless proves to be a weak comparison. As it has been convincingly argued, it would be a mistake, unfortunately prevalent in conventional historiography, to project the idea of psychology back to ancient Greece, particularly to Aristotle and his conceptualization of the psyche. ⁵⁹ This kind of approach, which looks for origins and predicates on a linear understanding of terms rather than historicizing them, ignores the differences and ruptures between ancient connotations of the psyche and modern concepts of psy-sciences; and thus ventures into ‘an uncritical equation of ancient and modern categories’. ⁶⁰ As Kurt Danziger reminded us, ‘Aristotle’s psyche is not the anima of his Latin translators, and even less is it the soul of the Middle Ages, let alone the mind of the moderns’. ⁶¹ From its Aristotelian rendering into its psy-scientific conceptualization, the psyche has been transformed from mainly an immaterial matter, provider of living form, into an empirically examinable matter of the (individual) human mind. ⁶² It is therefore not anymore synonymous with earlier concept(s) of soul, which is now framed emphatically as immaterial, transcendental or philosophical, hence systematically excluded from the idiom of Western psy-scientific language. Psyche, the scientised inversion of soul, has been instead reconceptualized as either the brain, mental apparatus or simply mind, and remained as the definitive concept for the modern psy-sciences, despite its composite genealogy, which is systematically concealed if not scientifically denied by modern psy-sciences.

Different than this process in the West, where it is now not possible to refer to psychiatrists or psychiatric hospitals in confluent reference to the (immaterial) soul, psychiatric hospitals in Turkey are still officially called the hospitals of sicknesses of the mind, soul and nerves (akıl, ruh ve sinir hastalıkları), a combination of concepts with old-spiritual and new physiological connotations fused with a sanitised, scientific meaning. The current dictionary of the Turkish Language Association still contains entries such as ruh hastalığı (sickness of the soul), which it defines simply as mental illness (akıl hastalığı) ⁶³; as well as ruh hekimliği (medical science of soul), which, according to the same dictionary, is the ‘medical specialty that deals with prevention, diagnosis, and treatment of sicknesses of the soul’. ⁶⁴ Psikiyatri (psychiatry) and psikiyatrist (psychiatrist) were also used interchangeably with ruh hekimliği and ruh hekimi (physician of soul). ⁶⁵

When we trace the concept of ruh in Mazhar Osman’s scientific publications, we thus find out the explanation that the ‘mental, soul or nerve illness expressions are used almost interchangeably [within the modern psychiatric terminology]’; they all refer to cases of ‘stricken souls’ (ruhu muzdarip) symptomized by hopelessness and listlessness; anger and exuberance; and amnesia and incomprehension, which are simply physiological symptoms, their cite being the cortex of the brain. ⁶⁶ In the same vein, Mazhar Osman openly refuted the old metaphysical understanding of soul (ruh), considering it a biological fact: ‘sicknesses of the mind are caused by defects in brain cells… Consequently, the soul (ruh), which was until recently confused with its philosophical meanings or taken transcendentally, is a physiological fact’. ⁶⁷

Even though he was resorting to a language full of historically overarching concepts embedded within the Islamic tradition, Mazhar Osman seemed to be confident in his writings on what the soul could physiologically be. Unlike the (Islamic) soul, which is the essence of life, in Mazhar Osman’s prose, the soul is simply reduced to the content of human consciousness (beşerin şuuru muhtevası), which is reflected through the activities in the neurons, and thus cannot exist without the brain (dimağ). ⁶⁸ Within this framework, the soul (ruh) becomes a part of the brain, and cognition is psychologically and psychiatrically centred in the ‘cortex of the forebrain’:

The soul is constituted by the overall activities and effects of the cells that are situated within the cortex of the brain, particularly the cortex of the forebrain (…) We know that there are cells in the cortex in which the bodily [physical] movements as well as feelings originate. There are also cells that enable thinking, ‘pensée’. The activity of the cortex of the brain, therefore, is the soul (…) and the main subject of psychiatry. ⁶⁹

Mental problems consequently emerge when there are physiological problems or distortions within the cortical cells: ‘If any of the cortical cells are damaged or cannot perform their functions, the individual loses the ability to think properly, and becomes a simpleton and dumb (avanak ve budala olur). And if the performance of those cells is perverted, there appear sickly ideas and manners. Hence that person is called mecnun and muhtel (mad and disturbed)’. Having a healthy soul (selim ruh), Mazhar Osman further emphasised, ‘is tied to a physically healthy brain (salim bir dimağ nescine bağlıdır)….’ ⁷⁰

Mazhar Osman methodically reiterated that psychiatry was a positive science (müsbet bir ilim); and it was mainly concerned with mental defects that were outcomes of examinable physical changes in the human brain. He nonetheless acknowledged that the psychiatric discipline was still in its early stages of development, and therefore its knowledge of cellular and neuron activities in the brain was still not advanced enough to be able to produce precise definitions or find exact cures. He was, however, quite optimistic about what the future held for this science and its potential to cure the mentally ill through exclusive medical methods based on new pathological findings. ⁷¹

Mazhar Osman also acknowledged the fact that, due to its current, limited level of knowledge, psychiatric diagnosis and aetiology continued to rely on psychological and psychoanalytical tools and methods to treat the mentally ill. ⁷² These methods, according to him, were reliable for psychiatry, as long as they were based on the experiments and observations over human emotions. ⁷³ The psychoanalytical methodology was developed to ‘penetrate the depths of the soul and to open internal lives up to objective methods’. It was through such ‘new methods [even] including dream [analysis], hypnosis, and [other techniques of] psychoanalysis’ Mazhar Osman was convinced that it ‘became plausible for [psychiatrists] to penetrate the darkest and hidden sections of the soul and diagnose the conditions of patients’. ⁷⁴

Mazhar Osman’s point in the abovementioned remarks on psychology and psychoanalysis, even though they might be read in contrast with his descriptive-biologist approach, was predicated on the idea that mental illnesses were physical, hence could be objectively explicated. After all, the methods and approaches that current psychiatry utilised (even including psychoanalysis), in spite of their shortcomings, were still able to help treat and cure illness in far more effective and predictable ways than older practices of healing. And that was what the new Turkish republic was fully determined to provide to its citizens by making necessary reforms as well as establishing modern medical institutions, such as Bakırköy Psychiatric Hospital, offering authorised medical services for the sake and benefit of the Turkish public. ⁷⁵ It was Mazhar Osman’s duty as a republican elite and expert to teach these valid scientific methods to the Turkish public so that they would appreciate such effective medical services, abandon previous superstitions, and become modern healthy citizens.

Ruh (soul), cin (jinn) and cinnet (mental disorder)

Despite the strictly physiological framework that Mazhar Osman offered through his psychiatric language, the employment of the same word ruh both within religious and medical discourses and domains in the Turkish case sweeps to undermine the material and immaterial binary that modern psychiatry defined itself through. This conjunction of the material and immaterial through language, despite the modern attempts to disjoint them, one might claim, points to a constant slippage or impasse of various fundamental binary structures of scientific and factual as against religious and superstitious, leading to an ambiguous and open-ended relationship that hinders a clear-cut contradistinction between religious and scientific discourses and their allegedly separate domains. For while the language hangs suspended in the rift between the psy-sciences and religion, many people suffering from soul or mind problems continued to move between psychiatrists and healers to find solutions for their problems. ⁷⁶ This indeed constituted a core problem for Mazhar Osman.

Yet, as anthropologist Jean Comaroff emphasises, is it not the case that ‘our sense of “truth” is always provisional, our evidence contextual?’ ⁷⁷ Accordingly, once one attempts to question our secular givens – and the absolute authoritative claims of (empiricist) science – it becomes obvious that what matters for the ‘reality’ of mental sickness is the way its language defines and reifies it. And Mazhar Osman, his colleagues, and their ‘traditional healer rivals’ seemed to revolve around two different ‘language’ options: the empirical scientific language of modern psychiatry as opposed to the transcendental language of religion or metaphysics. Please note that I am certainly not making the claim that mental disorders are simply myths, lies or phantasies. ⁷⁸ Instead, what I aim to do is to reflect on how Mazhar Osman appears to be one of the actors, if not the major actor, in early republican Turkey promoting the scientific option of ‘truth making’ for mental disorders within this linguistic context and its possibilities or limitations. Nevertheless, the etymological ambiguity over concepts such as ruh (meaning both the soul and the mind), which has been traced above reveals the different definitions and rationalisations of mental illness (i.e., material or immaterial forms) are part and parcel of complex everyday networks and practices, making the two supposedly opposite language convoluted and interrelated. ⁷⁹ This etymological ambiguity, I believe, represents a structural pattern that haunts the Turkish psychiatric terrain. There clearly seems to be a series of genealogically ambiguous concepts within the modern Turkish psychiatric discourse. One example other than the ruh that stands out is the concept of cinnet (mental disorder), which originates from the concept of cin (jinn), a spirit that is believed to possess [souls] and ‘mentally’ derange human beings.

A striking example comes from one of Mazhar Osman’s published papers, which speaks of the case of a school janitor called Süleyman, who was brought to Bakırköy Psychiatric Hospital on 16 July 1932 after he murdered and severed the head of an old woman. ⁸⁰ During his medical examinations, Süleyman insisted that he was possessed by jinns and spirits and was in a dream-like trance at the time of the killing. ⁸¹ Since the patient showed no observable sign of mental abnormality during his medical examination at Bakırköy, Mazhar Osman diagnosed Süleyman as suffering an instant or temporary case of mental disorder (cinnet) presumably triggered by his ‘superstitions’. ⁸²

What is indeed fascinating here is not only the clash of two different ‘realities’ explaining the same moment of loss of consciousness (i.e., being possessed according to Süleyman, and a case of mental dysfunction for Mazhar Osman) but also the linguistically overlapping terminology used by the two sides to describe the condition itself. Mazhar Osman’s medicalized diagnosis for Süleyman’s description of being possessed by the cin (jinn) is none other than ‘cinnet’ – albeit a secularised, scientised version of the original cin. The case of Süleyman further works to remind us that modern psychiatry was able to utilise and reconceptualize older traditional terms precisely because they had no equivalent proven scientific language to explain them, bringing out the slippage between traditional and scientific connotations of terms, and the different (yet connected) ways in which they were interpreted and reified among psychiatrists and patients.

Such slippages of the tongue and the meanings continue to exist even today despite psychiatry’s efforts to eliminate them for good. But how do current day psychiatrists approach these concepts? What sort of socio-political and cultural conditions provide the ground for these concepts to be perceived today by patients, their families, doctors, or the Turkish society in general? These are indeed anthropological questions, but a historical–genealogical approach, as I will further touch upon in the conclusion, might have some potential contribution.

Conclusion

Tracing early Turkish republican attempts for conceptualising ruh anew in a scientific, that is, material or physiological manner, together with the resistances or clashes of meanings it produced, demonstrates the complicated history of the transformations of the elusive and unordered categories of soul and madness into ‘objectively’ defined, classified, and rearticulated categories of psyche and psychic or mental illnesses in Turkey. Scrutinising such shifts first and foremost serves to remind us of the synchronicity and embeddedness of these ‘scientific’ transformations within the project of the construction of the modern state under the Republic of Turkey, its radical project of secularisation distending specific cords within Turkish epistemic modernity, as well as the global impact of modern psychiatry in particular and modern sciences at large. This is not an attempt to detach early republican Turkish psychiatry from global psychiatry, its empirical claims and power effects, but to focus on the ways in which the early republican conditions provided the ground for the psychiatric discussions to take specific forms, generating particular claims, emphases and agendas. The article hence demonstrates another example of how medicine (or science in general) is better understood in its context and the cultural and socio-political circumstances that have produced it.

As the main state expert and ‘father of Turkish psychiatry’, Mazhar Osman indisputably was a major contributor to these conceptual and epistemic transformations. Engaging with his psychiatric publications sheds light on how scientists armed with their scientific knowledge were active participants in the construction of modern Turkish nation-state. More importantly, an engagement with such publications makes it possible to situate their authors and their scientific expertise within the problem spaces of their eras, providing the ground for historicizing scientific claims enmeshed with socio-political aspirations and shaped through everyday clinical encounters. Such an engagement also involves an analysis of what one might call a process of conversion into secularity of a carnival of characters, including not only psychiatrists such as Mazhar Osman but also the patients, making it possible to reflect on their emerging secular realities or experiences, as well as their clashes, contingencies and interactive (linguistic) multiplicities.

The article has contextually traced the ways in which the republican language of denigrating the Ottoman past as the ancient régime unfolds within Mazhar Osman’s psychiatric publications, defining the Ottoman past as the opposite of science and progress. This is a bellicose secularist language constituting itself in oppositional relation to what it was now defined as superstitious and socially harmful, putting its stamp on Mazhar Osman’s psychiatric discourse. This discourse involves another conversion, that of from Ottomanness to Turkishness, or from being Ottoman subjects into Turkish citizens, utilising modern psychiatry as yet another vehicle to justify this socio-political transformation, defining the transformation as an outcome of progress and liberation, lifting the yoke of the older ways and regimes of mistruth. It is within this discursive framework, I argue that the transcendental ruh turned synonymous with the Ottoman past, whereas the scientised (and secularised) ruh came to reverberate with the republic.

This article has explicitly focused on how the transcendental Islamic concept of ruh had been attempted to be psychiatrically reconceptualized, and yet continued to be haunted by its early Islamic resonance(s) under the early republic. This is, however, hardly the end of the story. Ruh’s continued existence in Turkish psychiatric language to the present day continues to provide an active genealogical track laid with ruptures, contingencies as well as returns in which the ruh was (and remains to be) conceived in flux, unfolding under different settings and conditions. It is therefore plausible to trace it by and through the shifts in the socio-political contours of Turkish modern state, that is, pursue it all the way from the processes of liberalisation of Turkish economy during the post-World War II period, to the beginnings of the multi-party period in 1946 or the end of Republic People’s Party regime in 1950, followed by the Democrat Party era, marked by a significant loss of the secular grip of the Turkish state and the consequent return of religion into the Turkish public sphere. ⁸³

Such a search would further take us from the materialised or physiologically reformulated ruh of Mazhar Osman and the earlier Turkish Republic to the (yet again) spiritualized ruh of Ayhan Songar (1926–1997), an eminent second-generation biological psychiatrist and the last disciple and assistant of Mazhar Osman. It is within these shifts in secularism and socio-political circumstances in Turkey, the psychiatric conceptualizations continue to alter, deviate, rupture as well as align with earlier versions. Thus Songar warns his readers in the 1970s not to confuse the immaterial entity (the soul) with psychical apparatus (the psyche or mind), since ruh is the concept that is used to refer to them both. ⁸⁴ And despite continuing to practice psychiatry, he propounds a criticism of the secular sciences, which, according to him, construe a mechanistic world run by the so-called ‘laws of nature mythically aimed at replacing the laws of God’. ⁸⁵ Different than his mentor Mazhar Osman, studying physiology of the brain enabled Songar to ascertain proofs for the existence of a God capable of creating ‘wonders such as the human nervous system with an average of tens of billions of cells and an almost uncountable number of neuronal fibres’. ⁸⁶

Songar’s contributions were also not the end of the discussion over the issue. As secularism in Turkey has been immensely transformed under the Justice and Development Party (JDP) rule over the last two decades, so is the discussion being evolved in different directions within a context in which traditional methods such as prophetic medicine (tıbb-ı nebevi) are being revisited and officially authorised as alternative scientific methods under the JDP regime and its Ministry of Health. This process provides the almost exact opposite of the early republican era in which traditional methods were conceived harmful and unscientific, hence in need to be replaced by modern scientific methods, as discussed above. The same process also included a revised official approach to Ottoman history, identifying it not with backwardness or as the ancient régime anymore but instead as the celebrated glorious past of the Turks. Hence the dissolution of plausible correlations between the Ottoman past and the purportedly backward and detrimental concepts such as the immaterial ruh. These later examples and their possible constitutive interactions with early republican processes are indeed topics to be examined in detail elsewhere. Yet they might make it pertinent to conclude for now by accentuating a genealogical claim that this article tried to enunciate: what was or is conceived as ruh (and the psychiatric discourse it represents) in Turkey seems to be always in flux, endemic to constant processes of making and remaking under shifting socio-political and cultural circumstances, an open history of never ending (re)conceptualizations and discursive formations.