Culture Medicine and Psychiatry最新文献

Taking seriously the idea that liberation medicine should include, or even start from, the perspectives of those who are at the margins of the current medical system, this article draws on the perspective provided by a group of working-class writers who inhabit these margins, through an ethnographic story about medical failure and radical care. The story follows a middle-aged couple, Farid and Shakeela, residents of a working-class neighbourhood in Delhi, who travel to one of the largest public hospitals in the city for the delivery of their baby. Upon arrival, they encounter a hospital as a separate world, a space with its own rules and language, with maze-like pathways. Through the experiences of this couple, this article sheds light on some questions that help to theorize liberation medicine: In a medical system which is vast and overwhelming, does a labourer have any agency in finding a toe hold, or are they completely helpless and dependent on doctors, nurses, and technicians? Doctors diagnose an illness; however, who defines sickness? What makes a daily wage earner determine the condition of their health? Through reading this story, as well as the pedagogy of its writers, this article sheds light on the significance of networks of care which are easy to overlook whilst also calling for perfect institutions.

Since the 1980s, French police forces have used less-lethal weapons (armes à létalité reduite)-meant to neutralize targets without killing them-to enforce order. At first mostly deployed against working-class and racialized citizens living in the margins of French cities, they have been used against wider sections of the population during recent demonstrations against neoliberal reform. These weapons can cause severe injury, with longstanding physical, social, and emotional consequences. Moreover, citizens who suffer these injuries endure a stigma of criminality, making widespread social recognition of their pain difficult, which motivates them to look for acknowledgement of their victimhood in court. Based on 22-months of ethnographic research amongst people who have been mutilated or wounded with these weapons during police operations, this article is divided in two parts. In the first part, I describe people's bodily sensations-anger, tension, pain, etc.-while awaiting trial and during court hearings. I show how, much like the initial police violence, the process of waiting for justice, the events in court, and the final verdicts also become a form of violence that is inscribed on their bodies. In the second part, I turn to my interlocutors' close networks of support and care. In contrast to official proceedings, these networks allow for the refusal of socially attributed criminality and the acknowledgement and validation of their pain. I argue that they create a form of reparation that could serve as a model for a liberation medicine, a core aspect of which is the recognition of socially inflicted pain.

This article, based on a collaboration between an ethnopsychiatrist, a psychologist and an anthropologist at the Transcultural Psychiatric Operational Unit (TPOU) in Catania, Sicily, examines how a culturally sensitive approach can support migrants suffering from trauma, depression and other psychological or psychiatric disorders in their recovery and adaptation to the host society. First, we analyse the structure of Italy's migrant reception system and the specific characteristics of the public healthcare framework in Sicily. Next, we trace the history of the TPOU, detailing patient profiles and the facility's philosophy of care since its inception. In the second part, through an exploration of five individuals' therapeutic journeys, we illustrate how access to ethnopsychiatric services has facilitated their recovery and sociocultural integration. Finally, we underscore the disparities in access to treatment opportunities and psychosocial distress prevention programmes in Sicily, highlighting the absence of public facilities capable of providing culturally competent responses to migrants' social suffering.

Studies indicate that the lived experience of being a mental health service user is common among mental health professionals. However, little is known about how such experiences may influence clinical practice. Through interviews and diary notes from fourteen Danish mental health professionals, we explored how these experiences become part of everyday practices. Data were coded and analyzed following an abductive process incorporating the theory of social drama by Victor Turner. We propose a conceptual model of the transitional challenges faced by these professionals within the current social order of Danish mental health services. For some, the lived experience disturbed the social order to such a degree that they questioned their employment; for others, lived experience was either shared verbally or concealed from service users and/or colleagues in ways that did not disturb the social order significantly. The proposed conceptual model points to dichotomies of service users versus professionals and of madness versus normalcy as evident discursive practices within mental health services that do not favor mental health professionals drawing on their lived experience.

In mainstream doxa about global mental health, physical and tactile intervention on mental patients, such as corporeal containment, is frequently stigmatized and/or conflated with abusive practices. Nevertheless, in some Afro-Indigenous traditions, such as among the Miskitu of Nicaragua, certain forms of physical containment can be experienced as appropriate care, fostering somatic empathy. This article explores a set of misconceptions and conflations leading to a stigmatization of Miskitu physical containment, unduly associated to emblems of abusive restraint (e.g., straitjackets), and risks of sexual misconduct (2). By acknowledging the legitimacy of these fears, I argue that hauntings of psychiatric abuse must not be superimposed on practices that are superficially similar but substantially different in meaning, outcomes, and ethical implications. Drawing upon an ethnography of tactile care for grisi siknis (spiritual affliction) in Nicaragua, I explore the controversial practice of physically "touching" mental suffering through bodily containment. My aim is twofold: dissipating the false association between psychiatric abuse and any form of tactile mental care, and suggesting a broader reflection on the potentials of tactility for global mental health.

This article interrogates the diagnostic category of gestational diabetes mellitus (GDM) as a spectral illness, that is transitory, affectively charged, and shaped by regimes of anticipation and surveillance. Drawing on six months of ethnographic fieldwork in Vancouver hospitals, I trace how GDM is enacted not through embodied symptoms but through numerical thresholds, creating a clinical reality that arrives unannounced and often departs before it is ever felt. Despite its apparent disappearance, GDM leaves behind lingering traces: haunting fears of the return of chronic illness, maternal guilt, residual disordered eating tendencies, and the specter of intergenerational risk. Through a conceptual framework that brings together Derrida's notions of the hauntology, spectres, ghosts, and revenants; Fischer's temporal disjunctions of the "no longer" and the "not yet"; and other theories of 'at-riskness' and surveillance in medicine, I argue that GDM initiates a haunting that reconfigures the experience of pregnancy. It summons past traumas, elicits future-oriented anxieties, and embeds the maternal body within a terrain of ongoing clinical and moral oversight. As a diagnosis with a temporal expiration but lasting affective and embodied consequences, GDM demands new analytic attention to how biomedicine produces and manages uncertainty, anticipation, spectrality, and haunting.

This study investigates the psychological and social impact of the ongoing colonial violence in Gaza, both on the local population and on distant witnesses. Drawing on 30 testimonies collected between November 2023 and June 2024, the research captures the lived experiences from two distinct groups: 15 Palestinian participants living in the Gaza Strip, and 15 mental health professionals (including psychotherapists and academics) based in Europe. Using phenomenological and thematic analysis, the findings reveal the profound effects of genocidal violence on mental health, emotional resilience, and meaning-making processes. For Palestinians, daily exposure of bombardment, displacement, and systemic dehumanization undermines personal and collective agency, resulting in emotional numbness, anger, and alienation. Witnesses from European contexts reported helplessness, disorientation, and moral injury, often struggling with their perceived complicity in global systems of oppression. The study challenges conventional trauma frameworks, emphasizing the need to conceptualize colonial trauma as continuous, collective, and politically rooted. It argues for integrating social and political dimensions into psychological approaches to trauma, and highlight the ethical and political importance of bearing witness. Ultimately, the paper calls for a transnational process of collective healing and solidarity, aimed at dismantling the structural foundations of violence and dehumanization.

This study investigates the psychological experiences of Sri Lankan Tamil Refugees (SLTRs) involving boat journeys and the refugee lives that follow. Thirty participants from rehabilitation camps in Tamil Nadu, India, were interviewed. Reflexive thematic analysis was used to analyze the responses. The two overarching themes were 'the motives and consequences of exile' and 'the complexities of refugee life.' The findings reveal that the participants experienced psychosomatic symptoms immediately upon arrival, reflecting the inner conflicts resulting from war trauma and boat crossings. They reported serious bouts of trauma during and after their crossing. The first- and second-generation participants recounted nightmares pertaining to boat journeys which contributed to hauntedness, which is a state of emotional or mental disturbance often attributed to past trauma. Refugee life is complex, encompassing hopelessness and haunted memories which are passed down to subsequent generations, leading to intergenerational trauma. The boat journey in itself is an ambivalent phenomenon blending hope and profound agony. This study is a novel attempt to gain coherent insights into the boat travel experiences of the SLTR, the dynamics of the interplay of collective unconscious mechanisms, and anxieties in exile. These insights can play a seminal role in facilitating psychological reconstruction and developing effective coping strategies.

Body-focused anxiety refers to a wide range of negative emotional and social experiences centered around discontent with one's own body. This widely recognized phenomenon is mainly experienced by women across different contexts, often resulting from gendered socialization (Becker (1995) Body, self, and society: the view from Fiji. University of Pennsylvania Press, p. 2016). In modern Chinese society, it is important to understand these complex experiences within the quickly changing social landscape and ideas of womanhood. This study goes beyond clinical settings and the scope of mental illness (such as disordered eating or body dysmorphia) to include a variety of embodied experiences, including gender-related stress, negative self-awareness, and struggles in intimate relationships in the daily lives of young Chinese women. To grasp the current generation's body-focused anxiety, this research suggests examining it through the lens of intergenerational trauma, particularly the embodiment of patriarchal injustice reflected in the deeply connected relationship between Chinese mothers and daughters. Over 7 years, this article presents person-centered ethnography to show that some of the most intense body-focused anxiety among young women is an intergenerationally shaped existential crisis rooted in their mothers' upbringing within an explicit son-preference culture. As part of the intergenerational trauma, the body-focused anxiety is driven by (1) the mothers' unresolved girlhood trauma of being "born into the wrong gender"; (2) the desire to fulfill social obligations, which reflects both intergenerational trauma and the gender-specific challenges faced in a changing patriarchy. This analysis emphasizes that body-focused anxiety is not just a reaction to current social pressures, but a reflection of identities shaped across generations. It reveals that "becoming women" in a specific cultural context is transhistorical and closely linked to unresolved traumas from previous generations. Manifesting in different forms, understanding young women's body-focused anxiety from an intergenerational trauma perspective highlights how ongoing social forces are embodied even as cultural norms and social structures change.