Decolonising infant mental health: an anthropological provocation from Southern Africa

As an anthropologist working in the field of infant mental health in South Africa, a field heavily dominated by psychology and psychiatry, I’m interested in how disciplinary apparatuses take hold and how concepts, theories and analytic frameworks produce subjectivities, norms and social effects. Forged in the crucible of Europe’s violent world-making and its enduring legacies, Anthropology has long been (justifiably) accused of being colonialism’s handmaiden. The construction of ‘the Other’ was critical in structuring colonial hierarchies that continue to shape global suffering. It was responsible for the emphasis on difference that grounded apartheid. For decades, anthropologists have grappled with our imbrication in colonial knowledge formations (e.g. Asad 1973; Harrison 1991). I draw on this decolonial intellectual work to offer some thoughts about decoloniality in IMH.

Disciplines institute and govern specific knowledge formations. Decolonisation involves recognising that knowledge is implicated in inherited systems of power that may be exclusionary and damaging and may replicate harm. It involves understanding that what is taken for granted in our disciplines and our methods may be premised on specific ways of being and arranging the world and imagining relations (Tuhiwai Smith, 1999). For example, what we call ‘western’ models of the world imagine it as a resource available to augment human life – or at least, the lives of some. Yet, most indigenous peoples have a different model of the world, seeing humans as a component in a network of delicate human and non-human relationships, and emphasising harmony and balance. At the same time, it is easy to reify and romanticise these ideas.  We need constantly to be vigilant about our knowledge formations and the work they do. As bodies of knowledge practices, disciplines have the power to influence social fields. Sometimes they become resistant to critique. Recognising and remedying this, requires a reflexive stance, oriented to generativity, inclusion and non-harm.

Does IMH need decolonisation? This is an open question. Its scholarship is powerful, but its evidentiary base is narrow and may not reflect the richness of human experience. Its presumptions about relationship may be limited. The journal is to be commended for opening this opportunity to assess its premises, tools and methods critically.

As an outsider, I offer five provocations.

While acknowledgement of the WEIRDness of psychology’s evidence base is important, more research on its implications is required. A three-pronged approach would be useful: consideration of the historical and cultural underpinnings of concepts taken to be universal (including the idea of universality itself); a wider evidentiary base, drawing from a broader range of disciplines, transdisciplinary approaches, and including wider wisdoms; critical attention to how knowledge shapes practice and with what effects.

Increased focus on how diverse relational ties are made and sustained, especially where possibilities have been diminished by colonialism and contemporary curtailments. Here, I am gesturing to the ways that humans are encouraged into relations with others – human and non-human – more broadly, and with how those relations are imagined. Majority world relational ontologies (e.g. the idea of ubuntu in southern Africa) offer important cues. This does not replace a focus on maternal dyad but should prompt attention to the wider networks that sustain flourishing, and which are often made invisible by our disciplinary presumptions. Such attention will become increasingly important as the Anthropocene jeopardises well-being globally.

An anti-racist stance. Presumptions about otherness easily slip into naturalised notions of racialised difference. These have powerful and detrimental effects. Here is a recent example. Kohlhoff et al (2024) examine maternal depression, oxytocin, sensitivity and adult attachment style, and infant temperament in an ‘ethnically diverse’ sample of 106 mostly married, mostly well-educated Australian mothers. The study found that ‘non-Caucasian identity’ rather than depression or oxytocin levels predicted difficult infant temperament (p. 1; 2; 9-10). ‘Non-Caucasian’ is a post hoc descriptor that glosses ‘Asian…, Indian… and Arabic backgrounds’ (p.3). It conflates a landmass, a nation-state and a language category into an ‘Other’ to ‘Caucasian’. ‘Caucasian’ is not an Australian census category. Its mobilisation here produces a racialised framework. Although the authors note (p.9) that ‘non-Caucasian’ may be a proxy for other forms of difference, including language, marginalization, lower socio-economic status etc., none of these are explored. Instead, a recommendation for future research examining ethnicity and attachment is offered. This produces a pernicious racialised othering and normalises whiteness as the baseline for measurement.

‘Epistemological allyship’ and beyond. Seth Oppong (2023) developed this idea to invite wider networks of collaboration between psychology’s centres of power and excluded majority world academics in that discipline. I extend the notion here to suggest that we need to draw on other disciplinary formations and wisdoms not held in universities. One reason is that our disciplinary apparatuses can make us resistant to critique. Another is that our concepts can become closed and ineffectual, or worse, can be put to work in ways that might harm. Engaging with other bodies of knowledge, in both other disciplines and external to academia, could limit the echo-chamber expertise that sometimes bedevils disciplinary scholarship, and open productive questions of flourishing and well-being. There are already important examples of this in the IMH journal (e.g. Richardson et al. 2025).

Finally, a cheeky suggestion. For an outsider coming to the field of IMH, the significance of the concept of attachment, and particularly of maternal-infant attachment, is striking. It has the quality of a sacred object. Anthropologists have long observed that the current model of attachment is predicated on specific cultural values (including those relating to degrees of autonomy and dependence) and that a wide range of other models exist in majority world settings (e.g. LeVine 2014; Keller and Bard 2017; Vicedo 2017). Universalist presumptions about how and with whom infants form relations may miss critical and formative dimensions of infant experience. It might be worth asking what work the attachment to attachment is doing and what it might mask. For example, in many contexts in southern Africa, a key axis of well-being has to do with the infant’s relation with their ancestors; a form of attachment that has not been adequately acknowledged in the psychological literature and yet which can become pressing at various points in an individual’s life. Disregarding this disavows a vital dimension of social life, precluding attention to how absent-yet-present forces shape the worlds of infants. What other influences, modes of attentiveness and role players are rendered invisible when we attend too closely to the maternal dyad/primary caregiver? Who else might be in infants’ social worlds, playing important but under-recognised roles? What might the effect of these be on infant mental health? At what point does attachment cease to be an adequate explanation of infant experiences or for how they will come to relate?

As ideas about ‘optimal’ infant development circulate ever more widely through global organisations like UNICEF and WHO, it behoves us to think about the social, political and ethical effects of our precepts and concepts, and the evidence bases on which they are built. I have offered these comments in the spirit of scholarly conviviality (Oppong 2019; Nyamnjoh 2024) and with gratitude for the opportunity to do so.

References

Asad, T. (Ed.). (1973). Anthropology & the Colonial Encounter. Ithaca Press.

Harrison, F. (Ed.). (1991). Decolonizing Anthropology. American Anthropological Association, Arlington, Virginia.

Keller, H., & Bard, K. A. (Eds.). (2017). The Cultural Nature of Attachment. MIT Press.

Kohlhoff, J. L., Karlov, M., Dadds, B., Barnett, D., Silove, D., & Eapen, V. (2024). Maternal antenatal depression, oxytocin, and infant temperament: The roles of ethnicity and adult attachment avoidance. Infant Mental Health Journal, 1(13). https://doi.org/10.1002/imhj.22129

Levine, R. A. (2014). Attachment theory as cultural ideology. In H. Otto & H. Keller (Eds.), Different faces of attachment: Cultural variations on a universal human need (pp. 50–65). Cambridge University Press. https://doi.org/10.1017/CBO9781139226684.005

Nyamnjoh, F. (2024). Incompleteness, Mobility, and Conviviality. Langaa RPCIG.

Oppong, S. (2019). Overcoming obstacles to a truly global psychological theory, research, and praxis in Africa. Journal of Psychology in Africa, 29(4), 292–300. https://doi.org/10.1080/14330237.2019.1647497

Oppong, S. (2023). Epistemological Allyship: Psychology and Developing Societies. 35(1) 69 –86. https://doi.org/10.1177/09713336231152301

Richardson, M., C. Waubanascum, S.F. Waters, M Sarche. (2025). A decolonial perspective on Indigenous infant and early childhood mental health: Reclaiming Indigenous ways for the next seven generations. Infant Mental Health. Vol 46(4): 361-375. https://onlinelibrary.wiley.com/doi/10.1002/imhj.70000

Tuhiwai Smith, L. (1999). Decolonizing Methodologies: Research and Indigenous peoples. Zed Books.

Vicedo, M. (2017). Putting attachment in its place: Disciplinary and cultural contexts. European Journal of Developmental Psychology, 14(6), 1–16. https://doi.org/10.1080/17405629.2017.1289838

Authors

Ross, Fiona C.
Anthropology, University of Cape Town,
South Africa
ORCID: 0000-0001-9642-3670