Culture Medicine and Psychiatry最新文献

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.

Cultural consonance, defined as the extent to which one is able to approximate a given cultural model in one's own life, is a highly adaptive theory and method which anthropologists have used for decades to demonstrate direct connections between individuals' variation in relation to meaning systems and their health outcomes. However, it has been limited by use of a "cultural consonance score" which treats cultural consonance unidimensionally. Because people enact cultural models in multiple ways, cultural consonance may be better operationalized multidimensionally. Applying correspondence analysis to young South Korean men's responses to a cultural consonance scale measuring their approximation of the local ideal male body, cultural consonance is rather demonstrated to be a multiplicity. In the case of South Korean men's body ideals, two dimensions-men's overall attractiveness and whether they pursue a "flower boy" or a "beastly man" embodiment-are identified. These two dimensions are also significantly associated with university prestige and sexual identity, and predict disordered eating beyond body dissatisfaction. These data suggest that well-being in relation to cultural consonance is a product of its assemblage: both of degree of approximation of a cultural model and the manner by which individuals enact it.

According to psychiatry, Attention-Deficit/Hyperactivity Disorder (ADHD) is a chronic condition beginning in early life. Psychiatry advocates for early diagnosis to prevent comorbidities that may emerge in untreated cases. "Late"-diagnosis is associated with various hazards that might harm patients' lives and society. Drawing on fieldwork in Israel, we found that 'midlife-ADHDers,' as our informants refer to themselves, express diverse experiences including some advantages of being diagnosed as adults rather than as children. They share what it means to experience "otherness" without an ADHD diagnosis and articulate how being diagnosed "late" detached them from medical and social expectations and allowed some to nurture a unique ill-subjectivity, develop personal knowledge, and invent therapeutic interventions. The timeframe that psychiatry conceives as harmful has been, for some, a springboard to find their own way. This case allows us to rethink 'experiential time'-the meanings of timing and time when psychiatric discourse and subjective narratives intertwine.

In this paper, I share insights from ongoing ethnographic fieldwork among adult Danes who identify as having Attention Deficit Hyperactivity Disorder (ADHD) but do not meet the clinical standards and have yet to receive a diagnosis. These individuals are particularly relevant to the ongoing debates about under- and overdiagnosis of ADHD, as their claims to the diagnosis influence and mirror societal perceptions of what is considered normal and what is seen as a condition. Despite their symptoms not strictly meeting diagnostic criteria, thus risking overdiagnosis and associated psychiatric labeling, they perceive themselves as distinct from 'normal' people. Through a critical anthropological lens, I argue that medicalizing variations in human personality represents a contemporary societal epistemic error, drawing on Gregory Bateson's work. I highlight the dynamics of diagnosis versus notions of normality in diagnosing and self-diagnosing ADHD. Understanding these dynamics is crucial for addressing concerns of overdiagnosis as well as underdiagnosis and misdiagnosis. By illuminating the complexities of diagnostic processes and their societal implications, I aim to contribute to a richer understanding of mental health discourse and practice.

This essay is an ethnographic account of a volunteer, anonymous hotline of physicians and advanced practice providers who offer medical advice and guidance to those who are taking medications on their own to end their pregnancies. Attending to the phenomenology of caring on the Hotline reveals a new form of medical expertise at play, which we call "care with nothing in the way." By operating outside the State's scrutiny of abortion provision, the Hotline offers its volunteers a way to practice abortion care that aligns with their professional and political commitments and that distances them from the direct harm they see caused by the political, financial, and bureaucratic constraints of their clinical work. By delineating the structure of this new regime of care, these providers call into question the notion of the "good doctor." They radically re-frame widely shared assumptions about the tenets of the ideal patient-doctor relationship and engender a new form of intimacy-one based, ironically, out of anonymity and not the familiarity that is often idealized in the caregiving relationship. We suggest the implications of "care with nothing in the way" are urgent, not only in the context of increasing hostility to abortion rights, but also for a culture of medicine plagued by physician burnout.

Trans subjectivities continue to be included in major compendia of mental illness, despite recent moves to depathologize "cross-gender identification." Regardless, the inclusion of "gender dysphoria" is often framed as a formal mechanism to support access to gender affirming care as transgender subjectivities are re-conceptualized as part of sex/gender diversity and away from madness. The latter permits trans individuals to evade sanist oppressions. However, moves to disassociate from mad individuals also often serve to condone sanism. For instance, a contemporary policy landscape often sees transgender advocates arguing for the "medical necessity" of gender affirming care for gender dysphoria as a "recognized medical condition," thereby skirting the inclusion of gender dysphoria as a psychiatric condition and implying that gender dysphoria carries a special ontological status that separates it from madness (reified as "mental illness"). More though, this framework endorses material violences toward mad individuals that are often advanced via the workings of the state to consign marginalized constituents to death by withholding the means of life, i.e., necropolitics. In the following, I argue that trans disassociations from madness often endorses or assents to mad necropolitics. Drawing from Mbembe's (Necropolitics. Duke University Press, Durham, 2019) framework, I suggest that medicalizing trans narratives, despite being used to object to anti-trans laws in contemporary context, ideologically support mad "death worlds" organized through the U.S.A. welfare state and prison industrial complex. However, I also suggest alternative strategies, i.e., intersectional collaboration, that may uplift mad and/or trans communities.

A teaching theatre in a local psychiatric hospital was transformed into an ex-patient's Theatre of Dreams for over two decades as he hosted weekly events that welcomed patients from the wards, ex-patients and the general public to become an audience together. Movie Monday was a unique and innovative free weekly media arts programme that would become a valued community-arts programme that brought people together to be entertained while simultaneously addressing some of the society's most pressing and often divisive issues. The project ended when COVID locked down the hospital theatre. Now, the Movie Monday Archives are available to anyone online through Madness Canada. The Archives are a repository for the weekly programmes as well as special events such as the Reel Madness Film Festivals, and writings, photos, financial and programme details, and more. The Movie Monday Archives preserve this history of a local consumer-based initiative that engaged the arts to address mental health stigma and provide practical information of a potential model to build future initiatives elsewhere.