Culture Medicine and Psychiatry最新文献

Advances in end-of-life technologies increasingly destabilize received notions of personhood, identity, and ethics. As notions of personhood and identity within such systems are made to conform to discrete, binary and less fluid categories, some in the West have sought guidance in the techniques and views related to the dying process cultivated in other cultures, particularly Tibetan Buddhism. This article considers such dynamics as they unfolded in research focused on the postmortem bodies of Tibetan Buddhist practitioners in India. This article introduces the term thanato-technics to highlight the temporalities, imaginary or otherwise, evoked, enabled, and invested through the use of technologies to ascertain or conjecture about the intrasubjectivity of the dead and dying.

Understanding local worldviews is a challenge during clinical encounters, especially when they involve cultural references without acceptance from the medical community. Gangstalking is a Western cultural notion which refers to systematic harassment, surveillance, and torture from unseen or covert assailants or networks. It is not a 'real phenomenon' compared with genuine stalking, but experients report worse depression, post-traumatic symptoms, suicidal ideation, and longer lasting encounters. They report physical pain and impossible feats of espionage technologically orchestrated by unknown malevolent actors. Using conversational data from targeted individual podcasts, I explore gangstalking as a cultural concept of distress (CCD) by highlighting associated explanations, idioms, and symptoms. Clinically, gangstalking is likely diagnosed as paranoid schizophrenia. However, its association with frightening events parallels Susto and Nervios. Physical symptoms parallel Open Mole and Brain Fag Syndrome. Like many CCDs, gangstalking is a multi-dimensional phenomenon not neatly mapped onto psychiatric categories. Misinterpreting gangstalking cases as unique or isolated is a likely outcome even when they fit within a well-known Western subculture and techno-science belief system. Moving past prior, outdated notions of folk illnesses and culture-bound syndromes, gangstalking as a CCD helps end the assumption that only the other has exotic or non-psychiatric categories of distress.

Amid patriarchal conditions that render one son necessary and multiple daughters burdensome, selective abortion of female fetuses has become pervasive in India. Public responses often cast sex selection as self-evidently ignorant, cruel, and misogynistic - an obvious evil meriting denunciation and eradication. Drawing on ethnographic fieldwork in Gujarat state, this article zooms out from ultrasound and abortion to survey the landscape of biomedical, herbal, and religious son production techniques surrounding them. Doing so clarifies the lived moral experience in which sex selection is embedded. Resort to multiple son production techniques is both an abstract moral indicator reflecting prevailing concerns and a pragmatic moral intervention aimed at harnessing every available means in response to those concerns. Fundamentally, people live out the multimodal quest that sometimes leads to selective abortion as aspiration - social, bodily, spiritual - toward an indispensable good, not as heartless rejection of daughters. Pluralistic son production illuminates the moral uses of medical pluralism for care-seekers, social scientists, and policymakers and practitioners. The case underscores that "complementary" therapies, rather than being just desperate behaviors, barriers to biomedical therapy, or curiosities to be integrated into care, may in fact be the clearest markers of the moral conditions in which public health problems unfold.

In this article, I present the individual ethnography of Amina, a Senegalese woman possessed by the spirits of her lineage. Amina's story shows the lacerations of a person who simultaneously inhabits two worlds: the traditional Lebou culture and the Western one. When her spirits manifest themselves, she is forced to choose between two different interpretations of her suffering: the traditional persecutory and the Western psychopathological. She chooses the former but refuses the healers imposed by the tradition and turns to a priest of her choice, who proves to be sensitive to her need to personally own the healing journey. Amina strategically manipulates the plasticity of the traditional belief system without abandoning it; she bends it to shake the boundaries of herself, and her group and lineage. She uses the disruptive potential of possession and the irruption of the invisible world in the visible to renegotiate her role and acquire a new status in her group. She uses the performative dispositive of possession to renegotiate and expand her spaces of agency and affirm her tenacious subjectivity of a permanently liminal person, one who inhabits, shakes and redraws the boundaries between different worlds of meaning.

This paper explores the intricate interplay between living with mental illness and the processes of identifying mental illness in Abeokuta, Nigeria. With a particular focus on the contextual understanding of personhood, this study reveals how sociocultural backgrounds modulate the understanding of mental illness and its treatments within the Yoruba context. Through nine months of ethnographic fieldwork and discursive narrative analysis, the research revealed that becoming a mentally ill person is deeply intertwined with the everyday social life in the study site. The analysis highlights the multifaceted nature of personhood, encompassing various aspects such as parenthood, friendship, employment, and financial freedom. These facets of personhood are shaped by specific social practices and embedded within complex webs of social relations, often becoming more pronounced when these relationships are disrupted, leading to certain behaviours being categorised as mental illness. This paper underscores the significance of recognising and acknowledging the contextual notion and understanding of mental illness to ensure the provision of acceptable and effective care and recovery strategies.

Loneliness among young people has been increasing in recent years and is considered a major public health problem. This article delves into the sociocultural dynamics that favour the experiences of loneliness. For this purpose, 40 students between 19 and 24 years of age were interviewed using the photo elicitation interview (PEI) strategy. The results show a gradual normalization of the experience of loneliness and an effort to become accustomed to it. Virtual relationships and isolation linked to the COVID-19 pandemic are considered the two factors that have most enabled a climate prone to loneliness. Young people identify a few elements that feed social loneliness, such as an understanding of instrumental relationships, a scarcity of intimate relationships, a demand for hyperconnectivity, a fantasy of independence and a culture of positivity that hinders the establishment of quality social ties. Faced with hostile relational conditions, youth are sent into a cycle of loneliness. The greater the distrust of the environment is, the greater the defensive reactions and social distancing, and the greater the search for nearby spaces of refuge, security and shelter. Social withdrawal makes in-person relationships difficult and strengthens the need to isolate and become accustomed to loneliness.

Cultural beliefs influence the perceived cause, methods of diagnosis and treatment of mental illnesses. A qualitative study was conducted among traditional health practitioners (THPs) in the Harry Gwala District Municipality to further explore this influence. Purposive sampling assisted in the recruitment of 31 participants (9 males and 22 females). The four key themes this study investigated in relation to mental illness included its causes, methods of diagnosis, common symptoms observed and treatment approaches used by THPs, and the system of patient management. Culturally, mental illness was reported to be caused by witchcraft and an ancestral calling in this study. Mental illness was predominantly diagnosed by spiritual intervention which included divination through consultation with the ancestors, familial background, burning of incense which can also be part of communicating with the ancestors and through examining the patient. The common symptoms included aggression, hallucination and unresponsiveness. Prevalent modes of treatment included the use of a medicinal concoction and performing cultural rituals where ancestors and other spirits were assumed influential. The duration of the treatment process was dependent on guidance from the ancestors. Most causal aspects of mental illness from diagnosis to treatment seemed to be influenced by cultural beliefs and ancestors.

This paper presents evidence that some-but not all-religious experts in a particular faith may have a schizophrenia-like psychotic process which is managed or mitigated by their religious practice, in that they are able to function effectively and are not identified by their community as ill. We conducted careful phenomenological interviews, in conjunction with a novel probe, with okomfo, priests of the traditional religion in Ghana who speak with their gods. They shared common understandings of how priests hear gods speak. Despite this, participants described quite varied personal experiences of the god's voice. Some reported voices which were auditory and more negative; some seemed to describe trance-like states, sometimes associated with trauma and violence; some seemed to be described sleep-related events; and some seemed to be interpreting ordinary inner speech. These differences in description were supported by the way participants responded to an auditory clip made to simulate the voice-hearing experiences of psychosis and which had been translated into the local language. We suggest that for some individuals, the apprenticeship trained practice of talking with the gods, in conjunction with a non-stigmatizing identity, may shape the content and emotional tone of voices associated with a psychotic process.

Morita therapy is known as a psychotherapy grounded in the culture of Japan, particularly its Buddhist culture. Its popularity in Japan and other East Asian countries is cited as an example of the relevance and importance of culture and religion in psychotherapy. To complement such interpretations, this study adopts a socio-historical approach to examine the role and significance of work in Morita's theory and practice within the broader work environment and culture of the 1920s and 1930s in Japan. Morita conceptualized shinkeishitsu as a personality disease and a social illness caused by an alienating work environment. He proposed a remedy that emphasized the subjective emotional experience of work. To his primarily middle-class clients and readers, Morita's reconciliation between the self and society and that between autonomy and compliance was persuasive and useful, providing a philosophy whereby they could integrate into the work environment without loss of self-worth. The socio-historical character of Morita therapy is vital to understanding its power and appeal during Morita's time. Moreover, it sheds light on the complex interrelationships between work, mental health, and society.

The arrival of Afro-descendant migrants, mainly from Haiti and the Dominican Republic, has led to the emergence of new discourses on migration, multiculturalism, and mental health in health services in Chile since 2010. In this article, I explore how mental health institutions, experts, and practitioners have taken a cultural turn in working with migrant communities in this new multicultural scenario. Based on a multisited ethnography conducted over 14 months in a neighbourhood of northern Santiago, I focus on the Migrant Program-a primary health care initiative implemented since 2013. I argue that health practitioners have tended to redefine cultural approaches in structural terms focusing mainly on class aspects such poverty, social stratification, and socioeconomic inequalities. I affirm that this structural-based approach finds its historical roots in a political and ideological context that provided the conditions for the development of community psychiatry experiences during the 1960s and 1970s, as well as in multicultural and gender policies promoted by the state since the 1990s. This case reveals how health institutions and practitioners have recently engaged in debates on migration and intersectionality from a structural approach in Chile.