The Empire of Madness: Why Psychiatry Must Rethink Human Suffering - An Interview with Khameer Kidia
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What does Khameer Kidia argue is the true purpose of modern psychiatry?
Welcome to the Madden America Podcast, your source for science, psychiatry, and social justice.
Hello everyone and welcome to Madden America. I'm Ayur Didhar, your host for today. I am an academic, a therapist, and the editor of MAD in South Asia. Our guest today is Dr. Khamir Kedya, and he has a really interesting history spanning continents and disciplines. Dr. Kiria is a physician and an anthropologist at Harvard Medical and at the University of Zimbabwe. He's a Rhodes Scholar and 2023 New America Fellow, and we are here to discuss his new book, The Empire of Madness, which calls for an end to psychiatry in its current form. Kamir, welcome to Madden America.
It's such a pleasure to be here.
All right, let's get started. You say that the purpose of psychiatry as it is is to anesthetise pain and send people back to work essentially. And for those who can't be sent back to work, to quieten them so the system can remain productive. In other words, you say that in its current form, psychiatry is the handmaiden of colonization and capitalism. So could you elaborate a little bit what you mean?
For most people, what psychiatry is doing is helping them to cope with symptoms. And that is a in and of itself, I want to point out, a worthy, a worthy cause, a worthy thing to do. Without psychiatry, there would be a lot of suffering too. Um, and that's something that we have to contend with when we think about how to put these Things in context. We can't just get rid of psychiatry entirely, at least not at the moment. And that's why I say when I open the book that I'm calling for the end of psychiatry or at least a kind of end. I want it to look like something different. But what I mean when I say that, you know, psychiatry helps to anesthetize the pain and allow people to get back to work. Um, uh, you know, I first started to realize.
This as an undergraduate here in the US when I went to college. So I went to Princeton and I'd never been to the US before I arrived here. And I Realized that I was struggling to cope with what was going on in school. You know, my grades weren't very good. There was a lot of reading. We had a lot to keep up with. And I looked around me and realized that many of my friends and colleagues were on stimulants. They were taking drugs like Ritalin and Adderall to help them to study. harder to pay attention to focus to concentrate And I ended up getting a referral from a friend of mine to a psychiatrist. And we started our assessment and within a few minutes she was like, You have ADHD and you know, the questions that she asked me, the questionnaire that I had to fill out, I didn't even have to lie to be able to
Qualify for a diagnosis of ADHD. The questions were about whether I was completing my assignments on time, whether I was organized or disorganized, whether I felt overwhelmed with my work. You know, very natural feelings for a stressed-out college student. And she gave me a prescription for Adderall, which ended up Helping me feel in the moment. Really good about the work that I was doing. It was very, very motivating. Stimulants were incredibly motivating for me and really helpful. They allowed me to get back to work. They allowed me to stay up. They allowed me to study. I ended up having a much more complex relationship with stimulants by the end of my college experience. I was, I was using them in ways that were actually making things worse for me.
And, you know, you could say that I was addicted to stimulants because they were starting to cause harm in my life. I fell asleep in a final exam at one point because I had stayed up for multiple days in a row. If I was a motivated college student who wanted to do well, who wanted to go to medical school, falling asleep in an exam was probably one of the most Awful things that I felt like I could do. What these stimulants were allowing me to do was get back to work and to be more productive. And so ADHD is a diagnosis that essentially pathologizes underproductivity. Back in Zimbabwe, I was one of the top high school students in the country.
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Chapters
8 chapters
1
What does Khameer Kidia argue is the true purpose of modern psychiatry?
0:05–5:37
2
How did Kidia’s personal experience with stimulants shape his view on ADHD diagnoses?
5:37–11:48
3
What turning points led Kidia to see psychiatry as a tool of colonialism and capitalism?
11:48–18:31
4
How does the case of Vanessa illustrate the limits of psychiatric gate‑keeping?
18:31–24:22
5
What is ‘cognitive liberty’ and how does it relate to his mother’s treatment?
24:22–30:07
6
Why does Kidia argue that medical debt should be treated as a mental‑health issue?
30:07–35:12
7
How can mutual‑aid models like Harari Quiz transform mental‑health care in Zimbabwe?
35:12–41:42
8
What alternative vision of ‘care’ does Kidia propose beyond traditional medical hierarchies?
41:42–47:56
Speakers
2 identifiedMore from Mad in America: Rethinking Mental Health
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A Mother's Journey Through Psychiatric Drug Harm and Healing
Using Lived Experience to Challenge Systemic Prescriber Inexperience in Antidepressant Withdrawal
Mercy, Magic, and the Medical Humanities: An Interview with Jussi Valtonen