Culture Medicine and Psychiatry最新文献

Self-harm amongst young people has risen significantly in recent years, yet existing models fail to fully explain its underlying mechanisms. This paper applies René Girard's theory of mimetic rivalry and escalation to self-harm, proposing that competition for social status and identity within peer groups and families may contribute to its development. In this framework, self-harm operates as a form of self-punishment, mirroring Girard's concept of scapegoating; a ritualised resolution to the tensions produced by mimetic escalation. The study explores how social media amplifies these dynamics by intensifying social comparison and reinforcing cycles of imitation and rivalry. Current treatments may be limited in their efficacy as they primarily focus on precipitating factors and crisis resolution without addressing the mimetic mechanisms driving self-harm. Integrating mimetic theory into clinical practice could offer a new framework for intervention, helping young people recognise and disengage from destructive social dynamics. Additionally, the paper highlights the potential for systemic and group-based interventions that target mimetic escalation within peer and family relationships. By understanding self-harm as a product of mimetic processes, this perspective offers novel insights for research, clinical practice, and public health strategies aimed at addressing the rise in self-harm amongst adolescents.

The metanarrative of biomedicine and "psy" discipline (psychology, psychoanalysis, psychiatry etc.) asserts that cannabis use is one of the fundamental causes of mental illness among different men in the Rushinga district of Zimbabwe. These metanarratives, however, appear to have universalised, medicalised and marginalised the conception and representation of mental illness as enmeshed in local epistemologies and ontologies of mental illness. Based on local epistemologies, elders in Diwa largely trace mental illness to discursive sociocultural explanations rarely linked to cannabis use. This paper answers the central question: How is the use of cannabis by different persons related to mental illness in the Rushinga district? I argue that community members, health providers and police officers want to think of persons, especially men, with mental illness as "mad" and immoral cannabis users who brought illnesses upon themselves and lack personal responsibility based on Western neoliberal and biomedical metanarratives. However, this framing is not helpful, it is detrimental to treatment and social reputation, as it bypasses local cultural explanations that may be protective and that offer clearer guidelines for treatment.

Understanding how bodies come to matter in eating disorder recovery is complex, particularly given the unresolved question of whether eating disorders are fundamentally about the body. Drawing on Analu Verbin's adaptation of Judith Butler's theory of performativity and Sarah Ahmed's body phenomenology, this paper examines how participants in a narrative and systemic group therapy program at a mental health clinic for eating disorders perceive themselves as recovering or recovered. We explore how the body is presented and understood in their recovery narratives, developing the concept of the 'troublesome body' to highlight the ambiguities these narratives reveal. The body in the participants' narratives is continuously shaped by an external gaze that alternates between recognition and concern, often oscillating between praise and scrutiny. Participants are tasked with cultivating a liberated, sensual body and a more natural relationship with food, achieved through therapeutic strategies such as establishing a mechanical eating pattern and 'neutralizing' the body in group settings. Yet the body resists, asserting its presence through physical sensations-rumbling stomachs and 'blobby' forms-that challenge these efforts. Crucially, the narrative and systemic group therapy is viewed by participants as pivotal in their recovery not because it resolves all eating disorder-related issues, but because it offers a collective space for 'troublesome bodies.' This space allows for bodies to exist without conforming to societal dichotomies or norms that are often imposed in other treatment contexts, thus, offering an alternative model of recovery where bodily ambiguities can be embraced rather than resolved.

The Tukdam Project directed by affective neuroscientist Richard Davidson at the University of Wisconsin-Madison since 2013 has investigated Buddhist practitioners in India entering a Tibetan Buddhist post-death meditative state called tukdam (Tib., thugs dam), where the body demonstrates attenuated decomposition and presents an altered postmortem chronology process. Through a collaboration of Buddhist monastics, Tibetan medical physicians, and biomedical researchers as well as neuroscientists from the Russian Academy of Sciences led by Svyatoslav Medvedev since 2020 and India-based National Institute of Mental Health and Neuro Sciences (NIMHANS) Centre for Consciousness Studies since 2022, an international collaborative team has investigated the phenomenon from an interdisciplinary and cross-cultural lens. Yet, despite the varied paradigms and intellectual lineages of the research teams, they have skillfully employed instruments of knowledge, markers of physiological processes, definitions of consciousness, and varied paradigms of ontological and epistemological realities in Euroamerican traditions of biomedicine and science and Indo-Tibetan traditions of Buddhism and medicine. This special collection explores perspectives from the anthropologists who have served as researchers, managers, and leaders of the Tukdam Project since its inception, striving to collaboratively integrate competing and synergistic investigative regimes in exploring the biocultural nexus of suspended life and embodied mind in meditated deaths of liberation.

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.

Unknown to science until recently, the postmortem state of tukdam has not yet been adequately explained in biomedical terms. One way to understand this phenomenon is through ideas of different cultural bodies and death processes, where tukdam emerges as a particular kind of Indo-Tibetan death. This article draws upon medical anthropological scholarship and literature in history of science and cross-cultural medicine looking at epistemological theories of perception where different ways of conceiving-perceiving and attending to the body contribute toward producing different medical bodies-and deaths. This epistemological approach has entailed the idea of one reality "out there," which I call into question. I argue instead for an ontological approach, where epistemology and ontology are collapsed so that different forms of conceiving-perceiving contribute toward different forms of being. Such an approach seems apt in the case of different cultural bodies and death processes that we encounter with tukdam and other extraordinary Tibetan death displays. I explore Yogācāra Buddhist philosophy and its Tibetan appropriations along with science studies, medical and ontological anthropology to sketch out theory for how ontologically distinct bodies might come about. Tantric Buddhist bodies and deaths emerge as largely incommensurable with, and invisible to, the modern medical gaze with its attendant Euroamerican regime of truth where visibility, quantification, and technological measurability set the grounds for the real. This regime also dominates in the European documentary film world, as I discovered while making a documentary on tukdam.

This article presents two cases from a collaborative study among Tibetan monastic populations in India on the postdeath meditative state called "tukdam (Tib., thugs dam)". Entered by advanced Tibetan Buddhist practitioners through a variety of different practices, this state provides an ontological frame that is investigated by two distinct intellectual traditions-the Tibetan Buddhist and medical tradition on one hand and the Euroamerican biomedical and scientific tradition on the other-using their respective means of inquiry. Through the investigation, the traditions enact two paradigms of the body at the time of death alongside attendant conceptualizations of what constitutes life itself. This work examines when epistemologies of these two traditions might converge, under what ontological contexts, and through which correlated indicators of evidence. In doing so, this work explores how these two intellectual traditions might answer how the time course and characteristics of physiological changes during the postmortem period might exhibit variation across individuals. Centrally, this piece presents an epistemological inquiry delineating the types of valid evidence that constitute exceptional processes post-clinical death and their potential ontological implications.