Culture Medicine and Psychiatry最新文献

The book Under the Gaze of Global Mental Health: A Critical Reflection offers a powerful critique of Euro-North American epistemology and biomedical universalism, which continue to shape global mental health policies and practices. The authors challenge the assumption that Euro-North American ways of understanding the mind and mental illness are universally valid, arguing instead that these frameworks reflect a colonial legacy with practical and epistemological consequences - particularly through the influence of international agencies.

As awareness of hikikomori has increased worldwide, the body of research has diversified, deepening our understanding of the subject. Nevertheless, qualitative studies on the subjective experiences of primary hikikomori remain limited. Within this context, this study aims to enhance understanding of the primary type of hikikomori by exploring their lived experiences through in-depth interviews. The analysis identified six interrelated conflictual themes, woven through social-existential strife. At the core of this struggle lies an intricate negotiation of self-worth and belonging amid the tension between individual vulnerability and societal expectations. An existential yearning for meaningful relatedness underscored these struggles, despite an apparent severance from the social world on the surface. The subjects appeared neither apathetic nor indifferent, but rather encapsulated in a complex web of conflicting forces, experiencing pain both when retreating from and venturing into the outside world. These experiences were deeply intersected with cultural and societal dynamics, including subtle and largely invisible pressures arising from contemporary norms of sociality. Capturing the meanings of withdrawal within the resonance of an affected person's sense of self and their view of the social world is thus crucial, given the friction inherent in contemporary pursuits of self-discovery and social connection. By linking psychological distress with structural and relational forces, this study also seeks to offer an integrative perspective on social withdrawal, yielding insights that extend beyond the Japanese context.

This article discusses experimental attempts and imaginaries of interdisciplinary healthcare in alternative group practices, focusing on health activist movements in contemporary Germany and their predecessors in the 1970s-to-1980s, West German 'Health Movement'. As new forms of working in primary care, these practices stand for reimagining medical practice as a sociopolitical institution, and its possibilities for remaking patient and doctor subjectivities. Both times, this activism is part of broader developments of social-cultural and political change, and pervaded with a stubborn, critical optimism in its potential to foster societal transformations that extend beyond the group practice as a physical place. I explore these experimental projects through Davina Cooper's (2013) concept of "everyday utopia", arguing for closer attention to the affects, desires and attachments healthcare professionals, and in particular doctors project onto them. Drawing on utopian studies and health activism literature, I take up Cooper's distinction between "imagination" and "actualization" to argue how, regardless of its success, experimenting with alternative ways of practising and working together makes current conditions in medicine bearable for those involved.

This article examines suicidality-including suicidal thoughts, plans, and attempts-among young women in South Korea through a processual-relational approach that I develop to foreground lived experiences rather than static risk factors. While public health and medical research often reduce suicide to quantifiable variables, even when considering social factors, I argue that suicidality emerges from the accumulation of challenges and individuals' shifting relationships to society. To support this claim, I analyze three life stories drawn from 15 months of ethnographic fieldwork (2021-2022) in South Korea, including interviews with women in their twenties and thirties. Over time, my interlocutors came to recognize that their suffering arises from long-term struggles with patriarchal environments and pressures of normative life paths, generating profound disillusionment and hopelessness toward Korean society. To better understand these experiences, the processual-relational approach moves beyond analyzing structural factors like patriarchy and rigid social norms by tracing the cumulative processes through which individuals gradually (re)interpret sources of suffering as structural rather than merely personal. This process fosters awareness of their marginalized position and cultivates a renewed relationship with society. By proposing this approach, this study contributes to scholarship on suicide by emphasizing temporality, relationality, and individuals' active processes of meaning-making.

Psychiatry is facing a crisis of credibility, fueled by public disillusionment with inflated claims about the etiological understanding of mental disorders. Overconfident narratives have emerged from a vicious cycle of certainty: psychiatry's desire to be recognized as a "real" medical discipline, the public's longing for clear answers and quick fixes, and the vested interests of the pharmaceutical industry. Breaking this cycle requires that mental health professionals reintroduce uncertainty as a foundational premise and cultivate negative capability, described as the ability to remain comfortable with ambiguity and doubt, both individually and collectively. This shift can be nurtured intellectually through conceptual competence and emotionally through engagement with the arts, particularly literature. Uncertainty invites complexity, offering a richer understanding of the interplay of biological, psychological, and social dimensions of mental health. By learning to tolerate and even value uncertainty, psychiatry can rebuild trust and renew its credibility.

This cross-sectional qualitative study investigates how Russian men with obsessive-compulsive disorder (OCD) experience and manage mental health stigma, focusing on differences between those with a clinical diagnosis and those who self-identify with the disorder. Through in-depth interviews with eleven participants, the research explores meaning-making, disclosure practices, coping strategies, and the impact of masculine norms on help-seeking. Findings reveal that self-identified men often leverage the OCD label for personal understanding and peer support, while clinically diagnosed men gain validation but encounter heightened stigma due to their formal status. Both groups employ selective disclosure and narrative reframing to navigate societal pressures. The study highlights the interplay between personal identity, social recognition, and institutional legitimacy, underscoring the need for gender-sensitive and culturally tailored mental health interventions in Russia. This work contributes to understanding mental health stigma negotiation in understudied populations and settings, offering insights into how diagnostic status, gender norms, and cultural-historical context shape lived experiences of mental illness.

Amid rising adult ADHD diagnoses in recent decades, this article introduces a cultural ecosocial niche theory of adult ADHD, suggesting that symptoms emerge within specific cultural and social contexts rather than solely from neurobiological differences. Through in-depth interviews with seven Australian women recently diagnosed with adult ADHD, complemented by photo-voice methodology, we show how ADHD symptoms fluctuated markedly across different social interactions. The study found that participants actively construct and inhabit cultural ecosocial niches where their traits achieve a functional fit with their social and cultural environment. These niches ranged from adopting the macro-cultural framework of 'neurodiversity' to build affirming identities and communities, to finding micro-social occupational niches in fast-paced roles where their cognitive style became an advantage. Each niche was sustained by a reinforcing feedback loop, where the environment (such as a supportive social group or a demanding job) reinforced the very traits and beliefs that initially attracted them to that niche. This study challenges the notion that psychiatric symptoms are confined solely within a person or solely outside in the environment. Instead, it provides a concrete example of how symptoms and their meanings appear at the intersection of both. These findings illuminate the complex ways socio-cultural settings can both constrain and empower, while highlighting implications for how we conceptualise and address adult ADHD in an era of increasing diagnosis.

Mukbang, a digital practice that originated in South Korea and has since become a global phenomenon, features individuals consuming large quantities of food on camera while engaging with online audiences. While existing studies have approached Mukbang through sociological, nutritional, and media-theoretical lenses, its unconscious appeal remains largely unexamined. This article offers a psychoanalytic reading of Mukbang as a mediated space where unconscious processes of desire, lack, and embodiment are activated. Drawing on five in-depth qualitative interviews with regular viewers, we explore how visual consumption engages psychic dynamics such as scopic jouissance, incorporation, and identification, often marked by ambivalence-between fascination and disgust, control and surrender, satisfaction and frustration. By integrating clinical psychoanalytic theory with cultural analysis, we argue that Mukbang functions as a contemporary dispositif for psychic regulation, allowing viewers to negotiate tensions around food, the body, and symbolic loss within a digital framework. This study contributes to broader interdisciplinary conversations on media, affect, and the cultural shaping of subjectivity.

This article explores how parents in Japan navigate the entangled terrain of caregiving and coercion in the context of involuntary psychiatric hospitalization. Drawing on qualitative interviews with parents whose children were hospitalized without consent, this study foregrounds the complex moral and emotional labor that caregiving entails under conditions of limited institutional support and deep-rooted familial responsibility. The analysis identified two recurring patterns in post-hospitalization relationships: one in which caregiving bonds are sustained but increasingly strained and the other in which hospitalization catalyzes shifts in family dynamics, enabling new forms of distance or reconfiguration. These trajectories were shaped not only by the child's condition but also by the presence or absence of external support, including care quality, and by parents' internal struggles with guilt, obligation, and ambivalence. By situating these narratives within Japan's long-standing reliance on the family as the primary site of psychiatric care, this article contributes to the debate on care, agency, and coercion in psychiatric contexts. It calls for closer attention to how families navigate moral uncertainty and negotiate caregiving roles within a system where family involvement is not only common but often prioritized in the admission process, particularly in cases of hospitalization for medical care and protection.