Cross-Cultural Psychiatry: Understanding Mental Health in a Global Context - Prof. Krishna, Study notes of Physical anthropology

Download Cross-Cultural Psychiatry: Understanding Mental Health in a Global Context - Prof. Krishna and more Study notes Physical anthropology in PDF only on Docsity! Cross-Cultural Psychiatry Studying mental Illness in context: Local, Global, or Universal? • Why is there a difference between how we organize, label, explain and treat Physical health and Mental health? – Culture – Personality – Power structure “Normality” • Vary widely throughout the world • Multidimentional concept • Appropriateness of Individual behavior to certain context and social relationship • Never uniform within a population • A cluster of attributes that is appropriate for a particular type of context: work, leisure, personal or social occasion “Controlled abnormality” • Individual or collective inversion of normal roles, symbolic inversions • Codes are deliberated inverted, flouted and becomes the “temporary norm” • Tightly controlled, when it happens how it happens, and for how long It lasts • “Letting off steam” • Religious states, Possesion cults, or the trance state for a shaman or glossolalia “Uncontrolled Abnormality” • Abnormal behavior as defined by the culture or society, occurring without a reason • Not controlled by social norms • The extremes of “uncontrolled abnormality” largely overlap with western psychiatric classifications The Comparison of Psychological Disorders • Are there aspects of normal and abnormal behavior that are universal? Not culturally bound? Pan-human? • Are the western nosology transcultural? • Determine whether mental illnesses can be adequately diagnosed and treated cross-culturally Approaches to the study of cross-cultural Psycihatry • The Biological Approach • The Social Labelling Approach • The Combined Approach Biological approach • Despite local variations caused by cultural factors; there is a biological basis to psychiatric disorders • Content of delusions and hallucinations are influenced by cultural factors but what causes those delusions and hallucinations have an organic origin • Diseases are universal entities • Labelling is the first stage; • Then they are subject to a number of cultural cues about that tell them how to play their role • Once labelled, it is the society that “delabells” them and releases them from the sick role • Value of this approach is that points to the social construction and maintenance of the symptomology of mental illness. Fallacy of the Social Labelling approach • Ignores the biological aspect of mental illness • Ignores some extreme psychosis, which seem universal in its distribution. • Since mental illness is a relative concept, there fore cross-cultural analysis in not possible. The Combined approach • Medical anthropologists use elements from both the biological and social labelling perspectives. • There is ethnographic evidence that disorders arising from organic brain diseases seem to be organized in all societies, including similar conduct, thought or affect; and constitutes disorders perceived as “uncontrolled abnormal.” • Clinical presentations are usually influenced by the local culture • Medical anthropologists suggest that instead of trying to fit the symptoms into western diagnostic categories, focus be put on symptom patterns. • Our understanding of somatization is in itself a reflection of western cultural ways of thinking. • Why do some people somatize while others do not? • Somatization in china: Hong-Kong and Nanjing • TCM: “listen with their body” • Illustrates the importance of understanding from a holistic point of view Cultural Somatization • Selection of a particular organ as the main focus of all symptoms and anxiety • Organ chosen has a symbolic or metaphoric significance for the group • Becomes the “embodiment” of core values and themes of the society • Different from the more personal, idiosyncratic forms of somatization where certain physical symptoms are unique to the individual. “Psychosomatic” • Implies a mind-body dualism • Assumes there are two classes of phenomenon, psychic (mental) and somatic • Part of western folk culture: suggests that the condition is not as “real” and somehow that the origin and course is the patient’s fault • If it is not in the medical text,it must be psychological • Theories: dualistic, multi-causal, systemic, physiological; • Anthropological theories: holistic, role of context, whether cultural, social, political or economic - all blend together in its origin, interpretation, presentation, and management of the condition •