Laurence Kirmayer is one of the most influential figures in cultural psychiatry today. A psychiatrist, researcher, and theorist, he serves as James McGill Professor and Director of the Division of Social and Transcultural Psychiatry at McGill University and Editor-in-Chief of Transcultural Psychiatry. Across decades of work bridging anthropology, psychiatry, and cognitive science, Kirmayer has advanced a complex view of mental health as inseparable from culture, history, language, and political power. His research ranges from Indigenous youth resilience and narrative medicine to the diagnostic metaphors—such as “chemical imbalance” or “trauma”—that reshape identity and possibility. He has helped pioneer integrative approaches that unite phenomenology and neuroscience, including a biopsychosocial model grounded in enactive and embodied cognition, as well as a person-centered, ecosocial framework for understanding suffering beyond reductive biological paradigms. His critiques extend to how psychiatric categories reflect colonial histories and obscure social causes, as well as how attempts to localize mental health interventions may still impose Western norms. Kirmayer’s scholarship on narrative, metaphor, and cultural psychiatry aligns with ongoing efforts by Indigenous psychologists and anthropologists to reframe trauma and healing through culturally grounded practices, as reflected in recent collaborative work calling for a decolonial turn in psychology. Drawing on 4E cognitive science, he proposes that metaphors are not simply rhetorical tools but embodied and enacted processes embedded in local social worlds. These shape how people experience distress and how clinicians make sense of it. His forthcoming book, Healing and the Invention of Metaphor: Toward a Poetics of Illness Experience (Cambridge University Press, July 2025), extends these themes by exploring how metaphor, narrative, and imagination shape suffering and healing across cultures, while offering a critical account of the symbolic and political frameworks embedded in contemporary psychiatric and biomedical practice. In this wide-ranging conversation, Kirmayer explores the politics of diagnostic language, the structural roots of suffering, and the poetic potential of metaphor to disrupt conformity and open new avenues for healing. From the medicalization of culturally normative expressions of distress to the reification of trauma, Kirmayer shows how dominant frameworks can limit imagination, flatten complexity, and displace political realities with individualized solutions. He calls for a psychiatry that listens not only to symptoms but to the metaphors and metaphysics that animate people’s lives. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. https://www.madinamerica.com/donate/ To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850 © Mad in America 2025. Produced by James Moore https://www.jmaudio.org