Where There are only Doctors: Counselors as Psychiatrists in Indian-Administered Kashmir.

In the last decade, over half a dozen local and international humanitarian organizations have established psychosocial programs to ameliorate the suffering of victims of violence in Kashmir. Many promote nonpharmacological trauma healing, such as counseling and psychotherapy, in contrast to the pharmacological treatments preferred by state mental health services. Although anthropologists have critiqued humanitarianism for its inadequate attention to local contexts, in this article, I attempt to go beyond this critique by focusing on the locals or 'nationals' who staff these organizations. Kashmiri psychosocial workers mediate between formal, international guidelines of psychosocial treatment, on the one hand, and local understandings of biomedical efficacy and care, on the other hand. I specifically show how counselors appropriate medical and psychiatric expert practices in their everyday work, not to increase their own prestige but to make their practice more legible to their patients or clients. As such, one of the unintended effects of psychosocial programs in Kashmir is the perpetuation of a medical model of care. Rather than being caused by a lack of knowledge of the local context, however, I argue that such borrowings are central to how psychosocial practices have been vernacularized in Kashmir. [ABSTRACT FROM AUTHOR]