ARTICLE IN PRESS

Social Science & Medicine 65 (2007) 1654–1665

www.elsevier.com/locate/socscimed

Exploring identity, culture, and suffering

with a Kashmiri Sikh refugee
Neil Krishan Aggarwal
Yale University, Department of Psychiatry, 300 George street, New Haven, CT 06511, USA
Available online 25 July 2007

Abstract

Anthropology, psychiatry, and other fields that primarily rely upon verbal communication face a certain tension: to
what extent is the information garnered accurate? How does accuracy change depending on context? Has the interviewer
provided a safe space for respondents to share personal experiences?
This paper explores concepts of identity, culture, and suffering with a displaced Kashmiri Sikh in a camp settlement in
the province of Jammu and Kashmir. First, I will provide a history of the province and my project. Then, I will select the
text of one respondent who uniquely claimed to follow two religions. Next, I will analyze the interview as ‘‘spoken text’’ for
content and ‘‘unspoken subtext’’ for context. Finally, I will show how the respondent draws upon culture and religion for
solace in an environment where secular state institutions such as the military and civil bureaucracy fail to provide justice.
We shall reconcile these strands of thought by conceiving of the interview as a text co-produced and co-consumed by
interviewer and interviewee and subject to interpretation.
r 2007 Elsevier Ltd. All rights reserved.

Keywords: Sikhism; Hinduism; Jammu; Kashmir; Refugee health; Interviewing strategy

Introduction Pakistani tribesmen invaded India to aid an

Since the creation of India and Pakistan in 1947,
the province of Jammu and Kashmir has remained a
major source of conflict. Majority Muslim popula-
tions in the northwest and northeast territories of
colonial India opted for the Islamic Republic of
Pakistan while middle lands with majority Hindu
populations became the secular Republic of India.
The princely state of Jammu and Kashmir presented
a quandary with its Hindu ruler and Muslim
majority. Sensitive to the situation, the state’s ruler
Hari Singh chose independence. Two months later,
Tel.: +1 216 224 4444.
E-mail address: neil.aggarwal@yale.edu
indigenous revolt among disenfranchised Kash-
miris, compelling him to sign the Instrument of
Accession and formally join India as an autono-
mous province. India referred the matter to the
United Nations. Neither country has abided by its
conditions: Pakistan was to remove its troops from
the annexed territories of Gilgit, Baltistan and the
Northern Areas while India was to hold a refer-
endum in Jammu and Kashmir to decide whether
the territory wants union with India or indepen-
dence. The province has been a theater in each of
India’s wars with Pakistan in 1947, 1971 and 1999
and with China in 1965.
In 1988, Kashmiri Muslim youth began the
current insurgency against the Indian state after

0277-9536/$ - see front matter r 2007 Elsevier Ltd. All rights reserved.
doi:10.1016/j.socscimed.2007.06.002
 ARTICLE IN PRESS
N.K. Aggarwal / Social Science & Medicine 65 (2007) 1654–1665
allegations of election fixing. India contends that
Pakistan uses training camps and foreign mercenaries
to arm this ‘‘terrorist’’ movement. Pakistan counters
by saying that it supports an indigenous movement
of ‘‘freedom fighters’’. Violence has resulted in the
displacement of over 200,000 Kashmiris, mostly
Hindus. Although no official statistics have been
recorded for political reasons, the common under-
standing is that most remain internally dislocated
within India with some migrating abroad.
I visited displaced settlements of the Kashmiri
Hindu and Muslim communities within the Jammu
region of the state in March and April 2004.
I worked with the Shiriya Bhatt Mission Hospital,
a local, non-governmental, multi-specialty polycli-
nic run by displaced Kashmiri Hindus. The organi-
zation treats all but caters specifically to displaced
communities, irrespective of caste, religion, or
socioeconomic status, receiving income from private
donations and an honor system of payment among
patients. The organization also enjoys close contacts
with settlement community leaders.
I proposed to conduct mental health screening in
the migrant camps. I worked closely with Dr. K. L.
Chowdhury, a Kashmiri neurologist who heads the
Shiriya Bhatt Mission Hospital and manages
psychiatric cases himself due to the lack of local
psychiatrists. I visited displaced camps and con-
ferred on mental health with camp activists. Camp
leaders then informed camp residents that free
screening would be offered for mental illnesses,
particularly for major depressive disorder, post-
traumatic stress disorder, and generalized anxiety
disorder using criteria from the Diagnostic and
Statistics Manual, fourth edition (DSM-IV). We
selected these disorders because they represented the
predominance of Dr. Chowdhury’s psychiatric case
mix. Patients would be referred to appropriate
psychiatric care outside of the Hospital in case they
met criteria for specific pathology.
Dr. Chowdhury corresponded with camp activists
so that I could conduct interviews. Respondents
preferred to speak in either Urdu or Punjabi,
languages of the region in which I am also fluent
as a heritage speaker. Having spent that entire final
year of medical school in elective psychiatry
rotations, I was qualified to interview, take history,
and screen for the disorders in question. However,
I had not yet begun a psychiatry residency, so it was
decided that the Hospital would make arrangements
for interviewees who requested care or met criteria
for a disorder. The Hospital also provided trans-
1655
portation. I conducted the standard psychiatric
intake interview, but included questions on pre-
migration, migration, post-migration, and accul-
turation as recommended by Bemak, Chung, and
Pedersen (2003). Respondents were encouraged
only to share information if they felt comfortable.
Approximately 100 people sought to speak with me
over 60 days.
Although this project originated from questions
on cross-cultural psychiatry, my findings bear
relevance for the social sciences. At several points,
differences in disciplinary approaches became evi-
dent. To start with, the idea of conducting inter-
views to screen psychiatric disorders in a non-
Western population runs counter to ‘‘category
fallacy’’, the imposition of one culture’s diagnostic
criteria onto another culture, developed by Klein-
man (1977). Many Indian psychiatrists acknowl-
edged a possible lack of cultural correspondence,
but countered that they themselves are trained in
Western biomedicine and achieve respectable treat-
ment results over their practice lifetimes. Moreover,
how should they cross-section society were they to
develop an indigenous DSM? South Asia houses
many subcultures which transcend political borders.
Would the Indian province of Punjab share diag-
nostic criteria with Pakistan Punjab given historic
sociolinguistic ties or with the Indian province of
Tamil Nadu given a new, shared, political identity
within post-colonial India? Although psychiatry
needs to confront these issues, such questions should
not be an impediment to action.
Furthermore, once we have accepted the validity
of DSM criteria for a cultural context, a problem
arises with conveyance. Few psychiatric instruments
translated into Indian vernaculars exist. Stewart
suggests that translation implies a faithful transmis-
sion of both words and concepts from a source to a
target language, since language ‘‘structures the
conceptual world of any culture to the point where
certain thoughts cannot be entertained in a given
language and those structures that prevail in a
language will reflect what is significant to its host
culture’’ (Stewart, 2003, p. 370). Because many
Indian vernaculars have not developed a clinical
psychiatric vocabulary, some psychiatrists informed
me that they translate for patients based on intent
and not grammar, as Barrett (2004) has done among
the Iban. I also followed the same benchmark by
translating intent.
The responses of one Kashmiri Sikh refugee
warrant particular attention. Sikh tradition holds
 ARTICLE IN PRESS
1656 N.K. Aggarwal / Social Science & Medicine 65 (2007) 1654–1665
that in 1699, the tenth and final spiritual leader
Guru Gobind Singh mandated that all men take the
surname Singh (lion), women take the surname
Kaur (princess), and that all keep the five articles of
faith (i.e., kesh—unshorn hair; kanga—comb; kir-
pan—sword; kaccha—breeches; kara—steel brace-
let) to reinforce the ideals of a caste-less society and
membership within one spiritual family. Hence-
forth, I shall refer to my respondent as Singh Sahib,
a common cultural honorific for older Sikh men
that also protects his identity. At the time of the
interview, Singh Sahib was a 45-year-old man who
lived in Jammu at one of the older displaced
settlements with his wife and two children, aged
14 and 21. I met with him over a period of 2 days for
a total of 4 hours. Although he holds a bachelor’s
degree and studied in English-medium schools, he
lamented his inability to obtain secure government
employment and had to work below his qualifica-
tions as a clerk in the private sector. Below, I will
present the relevant portions of the interview which
pertain to his conceptualization of identity, culture,
and soteriology.
Singh Sahib: a case study
A sense of abandonment, geographical and
emotional, pervades the camps. Nearly all migrant
settlements are found outside of Jammu proper.
Most are located between 15 and 20 km away from
the city, requiring between 40 min and an hour to
reach them. The state does not provide public
transportation, so I traveled by taxi everyday.
Displaced people live in abysmal conditions. Roads
in the settlements are not paved. The unkempt
landscape of weeds and brush measures over 4 ft tall.
Such growth harbors spiders, snakes, and other
animals that have attacked the settlers. Often, one
male and one female bathroom serve 50 families.
Ambitious men look for work; the less determined,
the sick, the elderly, and the adolescent pass time
outside in groups. Women busy themselves with
housework and cook outside on hot plates since no
ventilation is provided in government quarters. Camp
settlers and community leaders suspect outsiders,
cynical over false promises of economic development,
educational and employment opportunities, and
increase in relief aid. The camps faced common
problems, including dismal housing, distance from the
city, and lack of basic infrastructure.
One community leader informed on my second
visit to a particular camp that a Sikh gentleman
wanted to meet me after hearing of my affiliation
with the Shiriya Bhatt Mission Hospital. We met in
his government-issue ten-by-ten flat without win-
dows or ventilation in which he slept with his wife
and two children. I asked him the same series of
questions that I asked everyone:
Neil Aggarwal: How would you describe your
childhood? Were you happy in Kashmir?
Singh Sahib: The majority was Muslim, but
before, people were courteous (log meharban si).
When I graduated, I looked for work for four or
five years. Now I still have no work. I just receive
relief. I received work here only because this is a
Hindu state (ih ik Hindu praanth hega).
Since Singh Sahib mentioned religion immedi-
ately, I asked him about his:
NA: Do you believe in any religion? If so, which?
SS: I am a Hindu Sikh. Or a Sikh Hindu.
I believe in Sikhism. Religion is such a thing that
we can’t change it. Our Hindu Dharma is so vast
that we have no restrictions on it. Sure, we are a
Sikh panth [term used to describe a sect] but we
came from Hinduism. We left Kashmir because
of our religion. We say that people will come into
the Hindu Dharma fold. Hindus never say to
change their religion to others. The terrorists in
Punjab were wrong.1 I’m open-minded. I can live
with Muslims and Hindus. We never had a
problem with Hindus in the past fourteen years
in these camps. In Kashmir, it wasn’t like this.
We left in 1947 after relatives were killed. We left
in 1965 after Pakistan attacked us at night. Our
‘‘plus point’’ is that we returned and stayed there.
We should have left in 1947. No one was happy.
They [the Muslims] would say that Sikhs are the
cousins of Hindus, kill themy
Many displaced Kashmiri Hindus spoke of being
targeted on the basis of religion. I wondered if he
were also attacked given his visible religious
symbols:
NA: Please describe the circumstances of your
flight from Kashmir. When did you leave? Where
did you stay?
1
An allusion to the religious violence which gripped Punjab
throughout the 1980s and early 1990s as Sikh separatists fought
for an independent nation of Khalistan (land of the pure) against
the Indian state in retaliation for the state’s 1984 attack on the
Golden Temple, Sikhism’s holiest site.
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N.K. Aggarwal / Social Science & Medicine 65 (2007) 1654–1665
SS: We left Kashmir in April 1989. Our whole
family. My own family, my parents, and two
brothers. We came by car with five or six families
in the darkness. If a Muslim asked us where we
were going, we would say, ‘‘The Gurudwara [a
Sikh temple].’’ Everyone survived. We brought
several trunks, what we could fit. We were afraid
of the Muslims. We had to cover our belongings.
We left everything, our house, cows, TV, house
items, blankets, dishes. We were in agriculture.
We had fifteen kanaals. We receive three thou-
sand rupees per family. It didn’t matter if we
were four people, six people, or ten people. They
sent us to the camps. There used to be tents here.
At least in the tents, we had air. Now we have no
ventilation in these rooms. It is so hot herey
We spoke of the numerous problems afflicting
camp settlers and their potential solutions:
NA: In your opinion, what is the cause of the
problem in Kashmir?
SS: In the militants’ mind, there’s this concept.
‘‘Steal from India.’’ They take oil, eggs, clothes,
everything from the government. They take
government money. Muslims would wake in the
morning, read namaaz [prayer]. We would look
at this and say this is wonderful. This is
discipline. Now we see how they’ve acted. Maybe
as [former Prime Minister] Vajpayee creates a
temple where the masjid [mosque] was, there will
be a lesson for them in this.2 We still like the
good Muslims. We treat them like brothers. But
not the militantsy
NA: What is the solution for the problem in
Kashmir?
SS: If the Hindus and Sikhs joined the Muslims
for Independence, no matter what the central
government wanted, Kashmir would have been
independent. But we left. The government owes
us protection. We want our own housey The
Hindus and Sikhs need their own side where they
can live well. We need a separate piece of land.
From that, we will embrace Muslims more. They
2
A reference to the Hindu political right’s promise to build a
temple dedicated to the God Rama in Ayodhya. In 1991, a group
of Hindus demolished a mosque dating from the Mughal emperor
Babur (1526–1530 CE). Many Hindus believe that this mosque
was built over a temple’s ruins. The destruction of the mosque
with the intent of rebuilding a temple was widely perceived to be
an act of religious intolerance, leading to communal riots and a
backlash of Hindu temple demolition in Pakistan and Bangla-
desh.
1657
will see that we are strong and the government
cares for us. We want to love them, but love can
only happen with equals.
NA: How do you explain your current condition?
SS: Let me tell you a story. Our very first Guru,
Guru Nanak,3 used to travel with his devotees
Mardana, a Muslim, and Bala, a Hindu. The
three used to go from village to village, spreading
knowledge. In return, they would receive food. In
our Janamsakhis4 it is recorded that once
Mardana was feeling very hungry. He asked
Guruji to go into the nearest village so that he
could preach and they could receive food in
return. After he had preached, they were not
invited to stay and eat. In return, Guruji blessed
the village and advised them to be on their way.
Mardana was upset because he was still hungry.
They kept on traveling. A short while later,
Mardana asked Guruji to preach at another
village since he was still hungry. After he had
preached, they were not invited to stay and eat.
In return, Guruji blessed that village as well and
they were on their way. Out of hunger, Mardana
turned to Guruji to preach at one last village.
This time, after Guruji had preached, they were
invited to spend the night. That evening, they ate
extremely well. In the morning, when they were
about to depart, Guruji cursed the village.
Mardana was shocked. He couldn’t understand.
He asked Guruji, ‘‘Why did you curse the village?
They treated us so well. You blessed the
other villages when they didn’t even feed us.’’
Guruji replied, ‘‘I cursed the village so that it
would fall apart. That village had generous
people. If all of the virtuous people are in one
area, then the other villages would continue in
their greed. With this curse, now the generous
people will settle with the greedy and raise them
to virtuousness. We Kashmiri Pandits are like the
cursed village. We are the smartest, most
talented, and most generous in the nation. It is
as if Guru Nanak has cursed us to spread us
throughout the world.
3
Sikh tradition believes Nanak (1469–1539) to be the founder
of the Sikh faith and its first Guru.
4
Sikh tradition holds that these are tales which recount the lives
of the Gurus. As a Western, self-described ‘‘skeptical’’ historian,
McLeod (1980; 1990) views the tales as hagiographies.
 ARTICLE IN PRESS
1658 N.K. Aggarwal / Social Science & Medicine 65 (2007) 1654–1665
Culture and identity as spoken text
Singh Sahib’s responses depart considerably from
modern Sikh orthodoxy, especially with regard to
Sikhism’s relationship with Hinduism. In 1899, Bhai
Kahan Singh, an intellectual of the Tat Khalsa
movement within Sikhism, published Hum Hindu
Nahin (We are not Hindus), a pamphlet structured
as a dialogue in which a Sikh refutes the arguments
of a Hindu who claims that Sikhs are part of the
broader Hindu community. At the conclusion of the
book, the Sikh addresses his community: ‘‘O
brothers, followers of Guru Nanak, I am confident
that having read this book, you will consider
yourself as a Qaum5(Sikh) and will realize that
‘We are not Hindus,’ and will consider all Indians as
your part’’ (Singh, 1984, p. 157). In 1925, the
Shiromani Gurudwara Parbhandak Committee
(SGPC) assumed control of most gurudwaras
throughout India. Styling itself as ‘‘the Parliament
of the Sikh Nation’’, it convened a committee in
1931 and 1932—in which Bhai Kahan Singh was a
member–and published the Rehat Maryada (Code
of Conduct) on how one should behave within the
gurudwara. It opens with the definition of a Sikh:
Any human being who faithfully believes in One
Immortal Being, Ten Gurus, from Guru Nanak
Sahib to Guru Gobind Singh Sahib, The Guru
Granth Sahib, the utterances and teachings of the
ten Gurus and the baptism bequeathed by the
tenth Guru, and who does not owe allegiance to
any other religion, is a Sikh. (SGPC, 2006)
Orthodox conceptions of Sikh identity can be
traced historically. Sikh identity was contested
between 1873 and 1920 as an emerging lower middle
class of Sikh professionals and intellectuals known
as ‘‘Tat Khalsa Sikhs’’ used modern print culture
and education to promote their textually derived,
uniform, normative identity over locally derived,
pluralistic identities which integrated Sikh scripture
with existing tradition and folklore and permitted
for a variety of beliefs, sanctioned by the religious
elite and landed aristocracy known as the ‘‘Sanatani
Sikhs’’ (Oberoi, 1994). Tat Khalsa historiography
has continued to label ‘‘Hindu’’ any belief that it
deems contrary to Sikh beliefs as a means of
negating and absenting social history (Oberoi,
1992). Community self-definition conflating ‘‘Sikh’’
with ‘‘Singh’’ identity coincided with the political
5
A difficult word to translate, it roughly means ‘‘nation’’.
ascendancy of the SGPC (1920–1925) as petty
commodity traders and local agrarians sided with
the Tat Khalsa movement against the colonial
British economy, integration into a failing world
market, and British patronage to Sanatani Sikhs
who controlled key religious shrines (Fox, 1985).
Janamsakhi and Rehat texts have differed over
which five physical symbols are mandatory, which
adherents keep them, and whom the SGPC’s
definition of Sikh includes and excludes (McLeod,
1992, 2000). Nandi (1996) has traced the historical
construction of contemporary Sikh orthodox iden-
tity by elite institutions such as the SGPC and its
political affiliate, the Akali Dal.
Consequently, many Sikhs within the tradition
perceive Western scholarship as an attack. Tradi-
tional responses have ranged from thoughtful
engagement to articulate the Sikh community’s
distinct identity throughout history (Grewal, 1997)
to polemics and ad hominem attacks (Mann, Sodhi,
& Gill, 1995; Singh, 1996). Public controversy has
even impelled the media to defend academics, as
when some Canadian Sikhs demanded Oberoi’s
dismissal after the publication of his book (Van-
couver Sun, 1994). Western academics, namely
Barrier (1993), Juergensmeyer (1993), and McLeod
(1993, 2000, pp. 267–279) have responded to
critiques against scholars investigating living reli-
gious traditions by differentiating a Western histor-
ical approach founded on skeptical inquiry from a
traditional approach founded on belief.
Despite criticisms, diversity within the Sikh
tradition continues to be identified. Singh (1999)
has explored the tremendous influence of the
Sanatani Sikh Udasi sect throughout history by
reviewing key land grants and studying specific
doctrines to explain their marginalization from
Sikhism after the ascendancy of the SGPC. Jolly
(1988) has studied the contemporary Nirankari and
Namdhari sects as sociocultural movements aiming
to purify Sikhism from Brahminical Hindu practice
throughout the nineteenth century. Caste has
persisted despite religious reform (Singh, 2000),
resulting in differential understandings of Sikhism
based on caste (McLeod, 1976, pp. 83–104), caste
mobility among Ahluwalias and Ramgarhias Sikh
castes (McLeod, 2000, pp. 216–234), the continu-
ance of Hindu life cycle rituals among some Jat Sikh
castes (Sandhu, 1981), and intra-caste conflict for
control over shrines (Jodhka, 2004). Social devel-
opments of Sikh militancy in Punjab have included
baptism and piety as acts of political resistance
 ARTICLE IN PRESS
N.K. Aggarwal / Social Science & Medicine 65 (2007) 1654–1665
(Pettigrew, 1995) and militant Sikh narratives which
construct the Indian state as Hindu, effeminate, and
weak (Das, 1992).
Diversity of practice exists more clearly in the
diaspora. Questions of language preservation
emerge, including the orthodoxy’s resistance to
translating scripture (Dusenberry, 1992), the in-
crease of transcriptions and translations of the Guru
Granth Sahib into English (Mann, 2004), and
language loss among first- and second-generation
children of immigrants in Malaysia (David, Naji, &
Kaur, 2003). The preservation of the five articles of
faith varies in the diaspora, such as its current
decline in America (Mann, Numrich, & Williams,
2001) and its symbolism of devotion and status in
England (Gell, 1996). La Brack (1983, 1988)
identifies 1904 as the start of Sikh immigration to
North America and shows how waves of immi-
grants after the 1950s persuaded older residents to
adopt the five articles as markers of identity. The
gurudwara as sacred space is also modified in the
diaspora, as a hybrid of architecture when con-
verted from unused Protestant churches in the
United States (Richardson, 1985) and as a location
of cultural transmission for language and music
(Cole, 2004). The diasporic militant Sikh movement
constitutes a polarized identity from a distinctly
male-, baptism-, and resistance-based subjectivity
through the Internet (Axel, 2004), commemorates
militants as martyrs through traditional dhadhi
musicians in England (Pettigrew, 1992), and repro-
duces militant narratives of suffering and martyr-
dom in America (Mahmood, 1996).
It is clear that no monolithic Sikh identity exists.
Within India, sects differ in their interpretations of
doctrine and practice. Outside of India, Sikhs have
tailored practices and rituals to suit new locales.
Kleinman (1999a) offers ‘‘the local world’’ as a
theoretical tool that asks ‘‘what exactly is at stake’’
in understanding the particularity of cultural and
social space, a model through which we can
understand the content of Singh Sahib’s identifica-
tion with Hinduism within the context of Jammu
and Kashmir. The Valley of Kashmir and the
refugee camp serve as the local world for Singh
Sahib. He refers to Jammu and Kashmir as a
‘‘Hindu state’’, a reference unthinkable in Sikh-
majority Punjab. He condemns the militant move-
ment in Punjab as ‘‘terrorist’’ and not a struggle for
a religious homeland. He mentions his family’s
difficulties in Kashmir during various wars with
Pakistan. He even refers to himself as a ‘‘Kashmiri
1659
Pandit’’ in his analysis of Guru Nanak’s life. Unlike
the case of Punjab, where Hindus and Sikhs have
defined themselves in oppositional terms, Singh
Sahib refers to Sikhism as a sect within Hinduism.
Perhaps the discourse of separation and identity
politics did not become salient within Jammu and
Kashmir.6 Singh Sahib clearly identifies with the
victimization of Hindus in the Valley and the camp
settlement. Although careful to distinguish between
‘‘good Muslims’’ and ‘‘militants’’, this distinction
shows that he implicates Islamists for militancy and
his current circumstances. The combination of a
common perceived perpetrator, the lack of a
significant Sikh population in Jammu and Kashmir,
and the absence of a rancorous sociopolitical
discourse between Hindus and Sikhs there may
explain how Singh Sahib views himself as a ‘‘Hindu
Sikh’’ or ‘‘Sikh Hindu’’. We can assume the
accuracy of his answers by accounting for diversity
in religious practice and his unique local world.
Transference and intersubjectivity as unspoken
subtext
In 1915, the Danish psychologist Edgar Rubin
made famous an optical illusion. Depending on
perspective, the image revealed either two black
silhouettes against a white background or a white
vase against a black background. Perceptual inver-
sion allowed the observer to discern how form and
background change based on differential gaze.
A similar inversion of text and context in this
interview may yield novel insights. Psychoanalysts
have long explored how the very interaction
between the interviewed and interviewer influences
the interview. Reviewing the literature on transfer-
ence, Abend (1993) summarizes: ‘‘The organization
of the drives and the complexity of how they are
modulated and expressed by each individual are
profoundly affected by accumulated experiences
with the significant persons in one’s childhood
environment, and in later life as well’’ (1993,
p. 646). Countertransference is intersubjective, in
which ‘‘the analyst’s subjective responses fused and
mixed with projected aspects of the patient’s inner
world’’ (Jacobs, 1999, p. 591). Lacan labels un-
certain feint speech as ‘‘this unknown in the
otherness of the Other’’ (Lacan, 1993, pp. 36–38).
6
This is difficult to assert definitively given the lack of academic
resources on Sikhism and Sikh identity within Jammu and
Kashmir.
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1660 N.K. Aggarwal / Social Science & Medicine 65 (2007) 1654–1665
Some social scientists have applied psychological
concepts to ethnographical analysis. Transference
and countertransference can influence the interac-
tion of different clinicians with the same patient in
the same clinical context (Good, Herrera, Good, &
Cooper, 1982). Life histories are ‘‘self-constitutive’’
in interaction with the Other such that any analysis
represents a particular moment and not necessarily
a social reality (Crapanzano, 1977, 1984). The
observer can use countertransference as ‘‘subtext’’
in analyzing the Other’s ‘‘manifest text’’ as a way of
understanding society (Stein, 1982, 2000).
How can transference and countertransference of
my interview be used as subtext in order to analyze
the ‘‘manifest text’’? Was I ‘‘seduced’’ unconsciously
through feint speech such that I failed to maintain
independence through a mistaken ‘‘countertransfer-
ential identification’’ as Robben (1996) warns
against? Like Fleisher (2000), I will analyze trans-
ference and countertransference for insight.
From the start, my positionality may have
influenced Singh Sahib’s transference. As an In-
dian-American funded by the American Association
of Physicians of Indian Origin (AAPI), a profes-
sional, ethnic organization with many projects in
India, the lucrative standing of my sponsors was
well-known. I spent 2 weeks in displaced settlements
prior to meeting Singh Sahib, so news about my
interests and affiliations may have spread through-
out camp communities. Indeed, Singh Sahib sought
me for an interview. Not unreasonably, perhaps he
viewed me as a way of obtaining relief.
My countertransference may have resulted in
wanting to help as many people as possible given
my complicated relationship with India. The
families of both of my parents suffered displacement
after moving to India as refugees in 1947 from what
is now Pakistan; this may have supplied me with
unconscious motivation to conduct this work.
Throughout life, the travails of my grandparents
have been consistently retold in family settings, so
perhaps I identified with my respondents and did
not want to cause them more hurt in challenging
their answers. Asking demanding questions be-
comes uncomfortable after taking advantage of
hospitality. Nearly every respondent insisted that
we speak inside their dwelling over tea, and any
refusal would have been construed as insult. Also,
when respondents learned about my family history,
it is significant that most responded empathetically
and collaborated with the interview. After I
returned, I presented my findings to AAPI and they
endowed money to cover a considerable portion of
the annual operating expenses for the Shiriya Bhatt
Mission Hospital, the first point of entry into the
health care system for many of the displaced. It is
possible that I sought those who would meet this
goal on some unconscious level. Out of discourage-
ment and respect for their hardships, I may have
discontinued interactions with those who doubted
my intentions.
Additionally, many respondents repeatedly em-
phasized that they deplored the inaction of visitors
to their settlements. They often criticized govern-
ment officials, politicians, actors, journalists, aca-
demics, businessmen, and other well-wishers who
visited the camps, altered the daily activities of
settlers, pledged relief, but then did not return. Still,
rather than shun visitors altogether, most took
chances to not work for a day in the event that relief
could be provided. Dr. Chowdhury repeatedly
emphasized that I not make false promises, lest
the settlers react negatively towards me for not
keeping my word and towards him for introducing
me to the community. The pressure to produce a
tangible result pre-occupied me after I would leave
the camps and could have manifested itself as a
dynamic within the interview. I certainly wanted to
direct as many people as possible to the Hospital
knowing that they would receive care and experi-
ence treatment firsthand.
My position as an outsider may have played an
ambiguous role in interactions. Some interviewees
may have preferred to restrict their responses
knowing that our encounters would be limited. At
times, interviewees appeared uneasy when questions
were asked about life before migration or specific
symptoms relating to current health ailments, even
though they sought me for the screening. For them,
no matter how I presented myself, I would have
remained a stranger asking personal questions. For
others, however, my status as a foreigner provided
reassurance that nothing would be repeated to
people whose opinions mattered. For example,
women often freely spoke of how the laziness of
husbands would stress them, confident that this
information would not be divulged since I had no
social networks at settlements outside of camp
leaders. It is difficult to estimate how this impacted
my interaction with Singh Sahib.
Transference, countertransference, and mutual
seduction may explain our views towards religion.
Singh Sahib may have seen me as a Hindu,
interviewing him within a predominantly Hindu
 ARTICLE IN PRESS
N.K. Aggarwal / Social Science & Medicine 65 (2007) 1654–1665
refugee camp, aided by a local Hindu organization
and sponsored by an American organization run
mostly by Hindus. He may have thought it strange
that I chose to ask about his religion, given his
visible observance of the five physical articles,
especially since we spoke in Punjabi. Singh Sahib
was targeted on the basis of religion in Kashmir. His
allusion to Hindu–Sikh violence in Punjab demon-
strated his awareness of the fragility of relations
there. Deeming my questions threatening, he may
have tried to minimize differences with me.
On the other hand, I asked him about his religion
for accuracy. I had met people in Punjab who had
converted to Christianity, but maintained the five
articles to avoid stigma from friends and family
members. I did not want to take his identity for
granted. I remember feeling embarrassed at the risk
of appearing naı̈ve, so my non-verbal cues such as a
sudden shift in position, not making eye contact,
and trembling of voice may have provoked his
anxiety. I felt discomfited to ask such an obvious
question, even if it were for the sake of methodo-
logical consistency, given the adversity he had
faced from his physical maintenance of religious
symbolism.
His response reveals a semantic paradox. The
very fact that he named both categories suggests
that he recognizes some sociolinguistic demarcation
between the words ‘‘Hindu’’ and ‘‘Sikh’’. Were he to
consider himself a Hindu, why qualify his response
with the additional label of Sikh? Initially, he adopts
the view of many modern Hindus who consider
Sikhs to be a sect within their community. However,
his subsequent responses position him within Sikh-
ism as a separate faith: he stayed at a gurudwara on
arrival to Jammu, he refers to Hindus and Sikhs
jointly as victims of militancy, his example of Guru
Nanak comes from the Sikh janamsakhi literature,
and he distinguishes Bala’s Hinduism from Guru
Nanak’s Sikhism. Perhaps he referred to himself as
a Kashmiri Pandit at the end to recall his initial self-
presentation as a Hindu.
I remember registering surprise at his comments.
I chose not to pursue that line of questioning
because of the discomfort it produced within me.
Given that my paternal grandfather’s name was
Nanak and that my mother is ethnically Punjabi—a
culture enriched by the contributions of the Sikhs—
I have long taken an interest in Sikhism. I have
heard some Sikhs claim to be a part of the broader
Hindu tradition and other Sikhs insist on their
separate identity. I have also seen how Hindu
1661
attendance at gurudwaras and Sikh attendance at
Hindu temples draws criticism from the orthodox of
both communities who insist that mixed practices
should be stopped. My shock may have prevented
me from exploring his beliefs further since I could
not rationalize them in the moment. Therefore, I did
not pursue the issue, relying on my own socializa-
tion in the United States to conceive of Hinduism and
Sikhism as discrete entities, partly to not offend him,
and, more truthfully, to not venture into uncomfor-
table mental terrain where I would have to confront
my Hindu family’s Sikh influence in a historical
moment which has demanded the construction of
these two religions as a discrete phenomenon.
Thus, our transference and countertransference
may have taken us into a mental space neither of us
originally intended. Our interactions may have
resulted in his feint speech and my seduction. Both
of our selves may have not wanted to disappoint the
Other and we may have colluded unconsciously to
navigate difficult conscious terrain. Reading the
interview as a text of context rather than content to
probe the unspoken, our interaction may symbolize
the conundrum of interpersonal communication. At
a very basic level, we embody different life
experiences. Although I wanted to help, I could
not promise that he would receive any direct benefit.
My limited resources of time and money were
essential to him. As a victim of political violence,
perhaps he perceived danger in disclosing personal
information openly. Our conversations may thus be
understood as an exercise through which we
unconsciously work out our interpersonal dy-
namics; we construct competing and cooperating
identities at different conversational junctions to
negotiate meaning for ourselves and each other.
I choose to retain the many conditional and
subjunctive tenses of the sentences to convey the
uncertainty that underlies interpersonal subjectivity.
While I suggest some foundational drives for my
interaction with Singh Sahib, ultimately I must
answer these questions for myself and indulge the
reader’s patience. My purpose is not to reveal
personal beliefs as much as to suggest that inter-
subjectivity often involves conscious and unconscious
impulses. Honest commitment to self-analysis may
reduce our biggest bias: ourselves. Such bias—
expressed through conscious and unconscious actions,
verbal and non-verbal articulations—should cause us
to interrogate notions of accuracy in the interview. We
may influence the answers of our respondents as much
as they do.
 ARTICLE IN PRESS
1662 N.K. Aggarwal / Social Science & Medicine 65 (2007) 1654–1665
Janamsakhi, suffering, and the work of culture
One aspect of the interview which displays
thematic unity is Singh Sahib’s response to my
question of soteriology. He offered a moving
account of Guru Nanak, Bala, and Mardana to
rationalize his predicament. Unlike many other
respondents who variously blamed politics, eco-
nomics, India, Pakistan, and the United States,
Singh Sahib invoked religion. How can we under-
stand this reliance upon culture?
Culture can be used as a tool for coping during
times of disturbance and uncertainty. In analyzing
how some Sri Lankans experienced depression as an
existential state rather than medical condition
within the context of Buddhism, Obeyesekere
(1985, p. 147) writes: ‘‘The work of culture is the
process whereby painful motives and affects such as
those occurring in depression are transformed into
publicly accepted sets of meanings and symbols’’.
People use religion to process terror in ‘‘post-terror’’
societies when secular institutions such as law
enforcement and security forces fail to administer
justice (Perera, 2001). Suffering is a social experi-
ence that affects the collectivity through a triangle
of ‘‘culture meanings, collective behavior, and
subjective responses’’ (Kleinman, 1999b). Narra-
tives can help people find order during tumultuous
times in their lives (Williams, 2000) and religion can
transform victims into survivors (Frank, 1985).
Singh Sahib’s narrative expresses the work of
culture through his usage of a janamsakhi. In
Jammu and Kashmir, the Indian government has
failed to protect its citizenry after 18 years of
violence, so religion provides him a sense of order.
Cultural tropes fit personal narrative to impart
meaning. Similar to his lived experience in Jammu
and Kashmir, it is notable that all three religions
find place in this narrative. The Muslim character
Mardana is regarded as ‘‘good’’, a follower of Guru
Nanak. The Hindu is also a sympathetic compa-
nion. The three religions live in harmony as the
characters missionize throughout their religious
journeys. Kashmiri Pandits suffer the same injustice
as the three heroes of the narrative. Given the
inherent divinity and spirituality of Guru Nanak,
the audience sympathizes with the plight of
Kashmiris. The connection between the subjectivity
of suffering and the cathartic nature of religion
characterizes the work of culture for Singh Sahib.
Although state apparatus cannot promise safety,
religion and culture make Singh Sahib’s conditions
bearable. Unlike many other displaced peoples,
Singh Sahib’s mental stability may result from the
transformative power of religion.
Discussion
This paper has attempted to demonstrate the
puzzle inherent within anthropology, psychiatry,
and other disciplines which rely on interpersonal
communication. How can we be sure that received
information is accurate? Is accuracy even the correct
word to describe the exchange? I do not mean to
suggest that respondents may intentionally deceive
us. Instead, we should remain more vigilant in how
we approach the interview.
Singh Sahib’s distinctive responses represent this
quandary of social science research. His remarks on
identity and culture do not fit within normative Sikh
culture. One approach may be to take inventory of
his surroundings to see how he situates himself
socially, historically, and culturally. This method
allows us to understand how a subject is constituted
and how a subject constitutes the world by placing
the subject in context. We can explain diversity on
local terms and ask if what we consider normative
really exists or represents our own pre-conceived
notions.
Another approach may question how interperso-
nal forces throughout the interaction shape his
replies. Like the Rubin image, our perspective on
text as foreground and context as background may
change if we invert our gaze. The unspoken subtext
must be analyzed along with the spoken. If the
interview stems from the interaction between inter-
viewer and interviewee, we can speak of co-author-
ship of the interview. Since this joint authorship of
verbal text occurs in real time, we read as we write
it. Co-habiting our roles as author and audience, we
must handle the ethics of content and the aesthetics
of context simultaneously. Unlike written texts, this
concurrent, bidirectional nature necessarily pre-
cludes any later return to spoken text. As the rules
of discourse change, we must learn how to read
and write the interview-as-text differently from
print-as-text.
As text, the interview becomes subject to herme-
neutics. At several points, Singh Sahib and I
manifested different interpretative practices. Does
this suggest that we read and wrote distinct texts
from the same raw materials or that we interpreted
the same text differently? In a criticism of literary
critics who posit that each reader produces a
 ARTICLE IN PRESS
N.K. Aggarwal / Social Science & Medicine 65 (2007) 1654–1665
different text based on the reader’s ‘‘interpretive
community’’, Dasenbrock elaborates on the concept
of ‘‘interpretive charity’’:
y to interpret another’s utterance we begin by
assuming provisional agreement on what we
believe to be true. But that provisional, heuristic
step is necessary only because as we actually
interpret, we encounter anomalies, sentences that
don’t seem to agree with what we hold true. Our
immediate reaction when we encounter difference
is to refuse that difference, to preserve the
maximum of agreement, and there are times
when this works, when we get away with
assuming that we are saying the same thing if
by different words. But the interesting moments
are when this doesn’t work so well, when we
realize that what we are interpreting does express
beliefs different from our own. (Dasenbrock,
2000, p. 288).
Both Singh Sahib and I uttered sentences which
may have challenged our understandings of the
world. To preserve our ‘‘maximum of agreement’’,
we may have refused difference stemming from our
beliefs. And yet, we persisted with the interview by
adopting an ‘‘interpretive charity’’ to reach a point
of accommodation. In every interpersonal commu-
nication, some conversational moves are excluded
as unsuitable (Grice, 1989, p. 26), so the question
arises as to how one should revisit those verbal
crossroads. Much can be revealed about ourselves
and our respondents in confronting forsaken
discursive paths.
Displaced migrants in Jammu and Kashmir face a
number of obstacles. India and Pakistan have
continued to fight a low-level conflict there for over
15 years. Poor rationing and administration com-
pound the loss of home and ancestral lands.
Differences in language and culture delay accultura-
tion. In light of these troubles, Singh Sahib draws
upon ‘‘the work of culture’’ as a resource to provide
personal meaning from a seemingly impersonal
religious narrative. This strong awareness of his
place in the world may have accounted for his
mental strength.
The above discussion assumes that culture and
identity in Jammu and Kashmir resemble their
counterparts outside. However, it is important to
also consider the possibility of new cultural forma-
tion as a response to war and displacement. We may
be witnessing challenges to conventional under-
standings of culture and religion. In the process,
1663
those like Singh Sahib may undergo an act of
identity adaptation or transformation. Only when a
state of normalcy has returned can we measure the
impact of economic, political, and cultural change
on the individual.
Workers in conflict areas must balance a desire to
provide relief with awareness that conscious or
unconscious gain may motivate respondents. No
easy solutions exist and we need to expand
discussions on professionalism and ethics in envir-
onments of trauma and deprivation. Anthropolo-
gists and psychiatrists must expand their scope of
research to capture how circumstance frames
conversation. While remaining sensitive to the
particularities of culture and history, we can try to
evolve broad theories on verbal communication in
situations of violence and relief. As a starting point,
secure locations should be found where respondents
can overcome perceived threats and take risks to
disclose information. Mental health professionals
may have to acknowledge cultural differences such
as the greater role of family and community in the
care of respondents. Stigma can be reduced through
increased efforts in psychiatric education and a
commitment to enlist local responders who may not
be psychiatrists. Our greatest impact, however, may
come outside of such settings of combat and
destitution as we advocate for those unable to
advocate for themselves.
Acknowledgments
I would like to thank Professors Byron Good and
Arthur Kleinman for suggesting several references
and Aliya Iqbal and Mark Breeze for their
comments on an earlier draft.
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