Culture Medicine and Psychiatry最新文献

It is commonplace to state that dementia is a complex condition. Such complexity involves the limits between pathological and normal aging, diagnosis with no simple organic causation, and the use of psychiatric medication that does not cure but generates hope to alleviate symptoms such as forgetfulness and delirium. Based on an ethnography of one year and a half (2017-2018) in a Brazilian metropolis, within a Public Geriatric center and the households of three families, I argue that dementia, more than a complex condition, is a generator of drug complexity. Following Stefan Ecks' reflections on multimorbidity and polyiatrogenesis and Karen Barad's understanding of intra-action, I discuss the polypharmacy present in most cases of dementia that I have known. Considering the complicated relations of medications with themselves and with time and places, I conclude that dementia should be seen a polypharmaceutical phenomenon.

Building on 12 months of ethnographic fieldwork among people with Alzheimer's disease living in Denmark, I argue that the loss of a sense of time caused by Alzheimer's is not a subjective loss, but rather an intersubjective one. Alzheimer's disease entails living with desynchronized rhythms, time that can be made painfully explicit, and numbers becoming increasingly tricky to manage. Drawing on Thomas Fuchs' theory of how individuals live in "basic contemporality," I explore moments of temporal rupture, and how people with Alzheimer's challenge their social relations due to their different sense of time. The article contributes to ongoing discussions about belonging. Taking inspiration from Tine Gammeltoft's description of how belonging entails fragile attempts at being part of something larger, and is thus a joint social practice, I show how one dimension of belonging's fragility is the inability to be in synch with social time. By proposing the notion of temporal belonging, I suggest that sustaining a sense of belonging is also about being able to participate in the rhythms and tempo of social life.

This study assesses the perspectives and experiences of Vodou priests (ougan) in the treatment of mental illness in northern Haiti. Our goal is to explore the etiology and popular nosologies of mental illness in the context of Haitian Vodou, through understandings of illness and misfortune which are often viewed as a result of sent spirits-or spirits sent supernaturally by others with the intent to cause harm. Using a qualitative approach, this study conducted semi-structured in-depth interviews with 20 ougan living near the city of Cap-Haïtien. Interviews highlight a sample of healers with little formal training who maintain beliefs and practices that differ significantly from current biomedical models. Ougan treat mental illness through a variety of means including prayer and conjuring of spirits, leaves for teas and baths, as well as combinations of perfumes, rum, human remains, and other powdered concoctions that are either imbibed or rubbed on the skin. The primary purpose of these treatments is to expel the spirit causing harm, yet they can often result in additional harm to the patient. Findings suggest that while ougan are willing to collaborate with biomedical practitioners, significant barriers remain preventing cooperation between these two groups.

Autscape is an autistic-led conference, organised annually in varying locations around England. Governed by a strict set of rules and regulations, Autscape is a social and spatial setup explicitly devised to accommodate the tendencies, sensitivities, and preferences of people on the autism spectrum. It is a design, in other words-as organisers and participants alike often profess-for an altogether autistic space. The uniqueness of the event, and consequently its value to anthropological theory, lies in the shared imagination of the setting by those who inhabit it as one in which neurotypical masks, otherwise worn daily in keeping with hegemonic society's expectation of conformity, can finally be removed. I introduce the concept of un-festival as a means of depicting this event, similar to festival in its goals of defiance and inversion, but different from-and in important ways, opposite to-festival in its style and architecture, in the dispositions it encourages and mobilises, and in its potential implications. The un-festival offers a powerful comment on this moment in history, whereby masks are no longer seen as an item that affords freedom, but as one that stifles it. While Autscape participants remain doubtful as to the actual effect of this event on neurotypical society, they do nevertheless express a desire that this project will have some longstanding effects. That once a space has been designed for autistic people that considers their specific needs and tendencies, autism may then finally cease to be interpreted through a neuro-normative prism and freed to be understood in autistic people's own terms.

The field of medical action extends beyond the clinical encounter. Rather, clinical encounters are organized by wider regimes of governance and expertise, and broader geographies of care, abandonment and violence. Clinical encounters in penal institutions condense and render visible the fundamental situatedness of all clinical care. This article considers the complexity of clinical action in carceral institutions and their wider geographies through an examination of the crisis of mental health care in jails, an issue of significant public concern in the United States and much of the world. We present findings from our engaged, collaborative clinical ethnography, which was informed by and seeking to inform already existing collective struggles. Revisiting the concept of "pragmatic solidarity" (Farmer in Partner to the poor: a Paul Farmer reader, University of California Press, Berkeley, 2010) in an era of "carceral humanitarianism" (Gilmore in Futures of Black Radicalism, Verso, New York, 2017, see also Kilgore in Repackaging mass incarceration, Counterpunch, June 6-8, http://www.counterpunch.org/2014/06/06/repackaging-mass-incarceration/ , 2014), we draw on theorists who consider prisons to be institutions of "organized violence" (Gilmore and Gilmore in: Heatherton and Camp (eds) Policing the planet: why the policing crisis led to Black lives matter, Verso, New York, 2016). We argue that clinicians may have an important role in joining struggles for "organized care" that can counter institutions of organized violence.

The literature suggests long-term consequences and lack of support for birthmothers following relinquishment of their child for adoption (Memarnia in Listening to the experience of birth mothers whose children have been taken into care or adopted, 2014). But there was not any work done to study in-depth experiences of birthmothers after giving away their child in Pakistan. So, the purpose of the present study was to explore the experiences of mothers who relinquished their child for adoption. As the present study was intended to explore lived experiences of a particular group, the phenomenological research design was used to conduct this qualitative study. An interview protocol was devised to explore the experiences of birthmothers. The sample was comprised of five birthmothers who relinquished their child for adoption and fulfilled the criteria. Semi-structured interviews were conducted with the birthmothers, and all the interviews were audio-recorded and transcribed before analysis. Interpretive Phenomenological Analysis (IPA) was used to interpret the transcripts of interviews. Further, data verification was done through peer scrutiny, by debriefing sessions with the supervisor, and enriches the description of the phenomenon. Four main themes were emerged: Reasons to Relinquish, Psychological Distress, Coping Strategies, and Disenfranchised Grief. The study present that the experience of relinquishment has a negative impact on birthmother and highlights the need for proper measures to regulate the process of adoption and involvement of psychologists during the process of adoption. Moreover, it stresses the need for acknowledgment of the experience and psychological services for birthmothers who relinquish their child.

Touch is a fundamental sense and the most unexplored of the five senses, despite its significance for everything we do in relation to ourselves and others. Studies have shown that touch generates trust, care and comfort and is essential for constituting the body. Based on ethnographic fieldwork, this study explores the absence and presence of touch in interactions between people with mental illness and professionals, in health care encounters with general practitioners, neurologists and physiotherapists, as well as masseurs. We found that touch and physical examination of patients with mental illness is absent in health care encounters, leaving the patients with feelings of being out of place, misunderstood, less socially approved and less worthy of trust. Drawing on Honneth and Guenther, we conclude that touch and being touched is an essential dimension of recognition-both of the patients' bodily sensations and symptoms and of them as human beings, detached from the psychiatric label-as well as contributing to the constitution of self and personhood. These findings confirm that touch works as an existential hinge that affirms a connection between the patient, the body and others and gives a sense of time, space and existence.

Susto is one of the most common disorders referenced in the medical anthropological and cultural psychiatric literature. This article questions if "susto" as understood in cultural psychiatric terms, especially in the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM), is in fact a single "cultural concept of distress." There is extensive cross-cultural and intracultural variability regarding fright-related disorders in the ethnographic literature. What is often labeled "susto" may be in reality a variety of distinct disorders, or lacking in the two signature components found in the cultural psychiatric literature: the existence of a "fright," and subsequent soul loss. There has been significant polysemic and geographical drift in the idiom label, the result of colonialism in Mesoamerica, which has overlayed but not necessarily supplanted local knowledge. Using data from fifteen years of research with Q'eqchi' (Maya) healers and their patients, we demonstrate how important variability in signs, symptoms, diagnosis, treatment, and prognosis of fright-related disorders renders any simple declaration that this is a singular "susto" problematic. We argue for a careful consideration of the knowledge of Indigenous medical specialists charged with treating fright-related disorders and against the inclination to view variability as insignificant. Such consideration suggests that Indigenous forms of fright-related disorder are not susto as presented commonly in the DSM and cultural psychiatric literature.

Men's body image is an issue of increasing importance as related illnesses continue to grow in prevalence around the world. However, cross-cultural attention to men's body image experiences has been relatively understudied. Based on data derived from cognitive anthropological methods of cultural domain analysis, I develop the concept of "muscularities" to more effectively examine the expectations inherent in multifarious models of body image men continuously navigate. Related to but distinct from "masculinities"-the recognition of culture-bound hierarchies of ways of doing-being a man-"muscularities" attends to the culturally particular ways in which muscles are conceived and evaluated as indices of socioeconomic status, intelligence, social skills, and professionalism, to name a few. Young South Korean men's experiences of chan'gŭnyuk ("small muscle") and manŭn kŭnyuk ("large muscle") challenge universalist assumptions about the kinds of muscles people value in global perspective, demonstrate the necessity of recognizing multiple muscularities in research, and encourage new directions of inquiry that attend to the consequences of variable embodiments of muscularities.

Obsessive-compulsive features are commonly found in high-achieving people including psychiatrists, psychologists, and scientists. These traits have a substantial but unrecognized cultural influence on psychiatric and psychological science and practice. This article reviews obsessive-compulsive mechanisms and discusses the ways they both promote and impede psychiatric and psychological science and practice. It examines them in relation to two of the dominant psychiatric and psychological paradigms of our era, the Diagnostic and Statistical Manual (DSM), and Cognitive-Behavioral Therapy. Finally, the article suggests that better awareness of our collective obsessive-compulsive tendencies can facilitate a cultural shift toward a broader, more useful science of mind and brain, as well as therapies informed by more comprehensive scientific understanding.