What
is culture and does one define it? In what ways are we as human beings able to
understand the various cultures that exist today? In class we are able to
understand culture in using the “social fabric” as a metaphor to explain health
in terms of social, economic, health care, cultural, and moral fabric. It can
be considered as a “safety net” or some sort of support network that if it is
broken it can resemble similar characteristics in identifying the social fabric
of health such that maintenance or repairs can be made. According to the
article read in class the fabric can be used by medical anthropologists as a
medium to explain, “health, illness, and healing that can be represented in
social and cultural images, society, and institutions, and ideas” (Janzen
1). I find it rather interesting that
all things medicine such as health, illness, and healing can be understood
culturally and socially. And according
to the article by Janzen, culture cannot be inherited, but rather it is learned
or taught via language. So in essence the social fabric, aside from being a
metaphor, means that in order to fully understand the healing process or
medicine, one must not only understand the science aspect, but also the
cultural aspect. Anthropologists see culture as part of the human genome and in
some respects it is part of the evolutionary process such that culture needs to
be adept to survive in ways animals do to survive whether it be in the change
of climate, food sources, to find shelter, distance, and to utilize technology.
“The unique way that a community of individuals organizes itself and marshals
its skills, knowledge, and energies to combat disease is thus a very central
part of culture” (Janzen 3). And thus to fully understand the healing process
of to seek an efficient approach to such process requires knowledge of other
cultures in their values and character.
In
the article, “living Through a Staggering World: The Play of Signifiers in
Early Psychosis in South India” discusses the role of culture in psychosis.
Interesting how we, in the western world, do not correlate culture and mental
health together. We often medicalize the issue of mental and behavior health,
but do not see the cultural and social aspect of it. In the case of
schizophrenia, some may see patients with this disorder as delusional or crazy.
In other cultures, some may see it as a spiritual deity using the patient as a
medium to speak through. Thus in interpreting such psychiatric disorders may
vary from culture to culture. Culture bound syndrome is defined as, “a
combination of psychiatric and somatic symptoms, believed to be only
recognizable within a particular culture or society” (Lecture). Interestingly
enough, it is not the disorder itself that is different from culture to culture,
but rather it is the symptoms. But for schizophrenia it is not particularly
applicable because it is absent from any biochemical or neurobiological
abnormalities. Nonetheless it is interesting to see how important culture is in
the understanding of psychiatric issues.
Back
on the issue of the article one must consider that the cultural contexts of
schizophrenia without objectifying the disease since it affects people
differently. Strauss and Estroff states that schizophrenia is an “I” disorder
such that the, “heterogeneity of course is the rule at a cross-cultural level”
(Corin, Thara, Padmavati). The article
goes on to explaining the research project at hand in trying to understand how
culture may shape the evolution of schizophrenia. The project was conducted in
Chennai, South India where 11 test subjects that were recently diagnosed with
schizophrenia and their family members were to be interviewed. Each of the
patients and their family members were interviewed in the language of their
choice to provide insight on their experience with schizophrenia in a
narrative. The interview would then be translated into English. Five of the
patients were Hindu, one Muslim, and one Christian. The researchers found that
Hinduism was a powerful signifier and so it was more focused on than the other
religions. Questions were more focused on “reconstructed perceived signs,
behaviors and feelings, meanings and reactions, coping strategies and
help-seeking, as well as modifications of interpersonal relationships and social
activities” (Corin, Thara, Padmavati) by the patients and their family members. In several interviews the patients were subjected to fear. Many subjected themselves to fear life and death in some paradoxical manner in which they questioned their very existence. Other patients were afraid of their thoughts being heard by others that their minds were being invaded. Interestingly enough, some resorted to religion for comfort. But their experiences and how it is narrated, one cannot merely understand what is is like to be schizophrenic such that the experience can only be subjective to the patients and though the interviews were translated to English, the cultural context in Hindi or the chosen language by the patient, cannot properly convey their experience.
(Cure 2011)
This picture reminds me of the interviews conducted in the article we had to read in class. Some of the patients narrated their experience about others trying to attack them or invade their mind. Others said that they felt as though others can read their mind. I cannot even fathom what their experience is like.
Resources:
Trialx. 2011. http://trialx.com/curetalk/2011/03/understanding-schizoaffective-disorder-vs-schizophrenia/
Corin et.al. 2004. Corin Etal2004-Living through a staggering world-the play of signifiers in early psychosis in South India.pdf
Schizophrenia is a disorder characterized by hallucinations, delusions, and social withdrawals. It is described as a disorder in western medicine; however, it is seen as spiritual possession in other cultures. Another example where culture plays a role in psychosis was mentioned in lecture and that was culture bound syndrome. There are cases where disorders differ from culture to culture and other times symptoms of disorders vary. With this, we can see culture plays a significant role in understanding psychosis. The article “Living Through a Staggering World” mentioned that we need to understand how cultural referents and interpersonal dynamics may shape one’s experiences and in turn shape the course of one’s schizophrenia. When the patients were interviewed, some of their narratives pointed to having overwhelming stress of fulfilling role expectations while others mentioned “black magic” and other “evil spirits” as the course of their problems. It seems that the delusions of the patients’ tend to reflect the predominant themes and values of an individual’s culture. For this reason, I would predict that the patient whom listed black magic and evil spirits as the cause of his/her problems is most likely religious because his/her culture most likely highly values religion.
ReplyDeleteI agree with Sophia when she says one must understand the science aspect as well as the cultural aspect when trying to comprehend the healing processes of medicine. Because different cultures see health, illness, and healing differently, it is of great importance to try and fully understand the values and beliefs of the patients’ culture,
only then can you help them in the healing process. I also wanted to point out that the language of a culture can present a huge obstacle in accurately diagnosing schizophrenia. In Corin’s article, the patients provided narratives in the language of their choice. The narratives were then later translated into English. We all know that one language cannot be transcribed into another language exactly word for word. Therefore, a lot of meaning can be lost through the process of making those translations. Psychiatrists may or may not make the diagnosis of schizophrenia depending on what they can understand with the narratives. To make it even harder to make a diagnosis, it is often times said that there are many difficulties for people suffering psychosis are amplified because what they are experiencing is unspeakable and inexpressible. This results in discrepancies between what a patient experiences and what they say they experience. We have talked about in class, in order for the physician to fully understand and help the patient, he/she must draw from different types of experiences whether it be the media, gender, church, etc.
I will be responding to a point the author made in the beginning of her blog post, “How Culture can affect Psychosis”. The author pointed out the importance of understanding culture in order to understand the healing process of an individual. The author wrote, “So in essence the social fabric, aside from being a metaphor, means that in order to fully understand the healing process or medicine, one must not only understand the science aspect, but also the cultural aspect.” In order to understand the patient’s perspective of a disease, it is critical that you also understand their cultural background. Whether it is a mental or physical disease, in order to treat the disease correctly and ensure that the proper medical treatment is recieved, cultural awareness is necessary.
ReplyDeleteI agree with the author’s point that in order to fully understand the healing process of an individual, you must also understand their culture and not just the scientific reasoning behind the disease and medicine. Her point reminded me of the class reading, “Managing the Unmanageable”, which is about the apparent noncompliance of elderly Russian Jewish émigrés who are being treated for diabetes. According to the doctors that treat this group of patients, they are generally noncompliant, demanding, frequently depressed, and do not follow the diabetes treatment that they are prescribed. The doctors reasoned that the patients could not follow the recommended diet restrictions because they could not control themselves from eating all the unhealthy American food that they did not have in Russia. The anthropologists that wrote this ethnography article pointed out that there were cultural reasons behind why the émigrés were not following their diabetic treatment. For instance, the ethnographers found that many of the émigrés did not follow the prescribed diet because they wanted to enjoy traditional Jewish foods. Also, they were unable to buy diabetic friendly food with food stamps and did not want to have to ask their children for help because they felt they should be the ones helping their children like they could back in Russia. Their behavior stems from their past life in Russia where they were used to Soviet medicine and the political economy of socialism. It is hopeful to note that the doctors treating the émigrés realized that the culture was causing a “barrier” to compliance because this means that culture could possibly be fit into mainstream medical care. Although the doctors did not correctly access the cultural reasons behind the reasons for the noncompliance, their attempt at cultural competence despite any cultural sensitivity training is hopeful. It is also important to remember that cultural competent medicine requires that both sides of the equation are looked at equally. Not only do you need to pay attention to the culture and beliefs of the patient, but also pay attention to the culture and beliefs of the doctor and health system. Both sides must go beyond the science and their cultural worldviews to benefit the patient and provide the most beneficial treatment plan. Also from another class reading, Nichter defined ethnophysiology as “…the study of how bodily processes are understood in different cultures and how such understanding influences perceptions of health, physical development, illness, medicines, and diet.” Overall, it is important to understand the ethnophysiology of a culture or group when treating them in order to know how to best provide them with medical treatment. This ties in to how it is important to understand a person’s cultural views to treat them and not just treat them solely based of their disease.
-Allison Binkerd
This blog entry talked about the possibilities of using culture to connect to mental health. The author talks about how the U.S often medicalizes the issue of mental health but not the social and cultural aspects of it. Also, you state from lecture the cultural bound syndrome as “a combination of psychiatric and somatic symptoms, believed to be only recognizable within a particular culture or society”. You refute that istead of the disorder changing between cultures, is is actually the symptoms. The author also references the research project in India for schizophrenia that measured the behavior, feelings, and reactions of the patients.
DeleteI found this article extremely interesting. I agree with the author, I believe that intergrating social/cultural components would be tremendously helpful for diagnossing/treating mental illnesses. As stated in the entry the U.S fails to focus on that measurement, persumably because they focus heavily on the biomedical aspect and more of the medical abnormalities of the brain. I was curious about the culture bound syndromeand how you refuted it is not the disorder that differs between cultures but rather the symptoms. One can only reason that the symptoms are different between cultures because of the different cultural aspects/factors they undergo. I had a friend who for a short period of her life suffered from schizophrenia so it was really hard to watch the video in your entry of Lalita. My friend had no problem taking the “physcotic medicine” and did a complete recovery. So I do believe that getting a deeper understanding of Lalitas culture would help us determine how we could have orchestrated a better solution to save her life. Gaining an understanding of the patients lanuage, cultural meanings and symbols will be useful to connect the medicinal treatment to the patient. Like the research study evaluating components like family structrues and religious beliefs in her society could have prevented things like the abuse from her mother and the rapists. Ultimately it could have potentially saved her life. I also connected this to the article, “Managing the Unmanageable”. In the article they talked about how the anthropologistst were able to get a better understanding of why the Russian emigrants weren’t cooperating in their treatment for diabetes. They discussed the viewpoint that the Russians weren’t conforming into the Western tradition and assimilating to their foods and medicines. The anthropologists found that it was not because they were in compliance but simply because in their culture they have their own way of dealing with it. I found it interested that they precieved diabetes in their culture kind of like old age. They accept the idea that eventually they will day of this old age. In the U.S sometimes they try to make death inevitable, whereas other countries have embodied it as apart of life. Breaking down a pateints cultural beliefs and connecting it to their mental way of thinking is proven to be beneficial to their treatment. I believe we must try to pull back our bias of thing biomedicine is the only solution, and open up to understanding culture espicially when dealing with mental issues like schizophrenia.
- Denden Embaye