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The publication of the Cultural Formulation Outline in the DSM-IV
represented a significant event in the history of standard
diagnostic systems. It was the first systematic attempt at placing
cultural and contextual factors as an integral component of the
diagnostic process. The year was 1994 and its coming was ripe since
the multicultural explosion due to migration, refugees and
globalization impact on the ethnic composition of the U.S.
population made it compelling to strive for culturally attuned
psychiatric care. Understanding the limitations of a dry
symptomatological approach in helping clinicians grasp the
intricacies of the experience, presentation and course of mental
illness, the NIMH Group on Culture and Diagnosis proposed to
appraise, in close collaboration with the patient, the cultural
framework of patients' identity, illness experience, contextual
factors, and clinician-patient relationship, and to narrate this
along the lines of five major domains. By articulating the
patient's experience and the standard symptomatological description
of a case, the clinician may be better able to arrive at a more
useful understanding of the case for clinical care purposes.
Furthermore, attending to the context of the illness and the person
of the patient may additionally enhance understanding of the case
and enrich the data base from which effective treatment can be
planned.
Psychiatric classifications created in one culture may not be as
universal as we assume, and it is difficult to determine the
validity of a classification even in the culture in which it was
created. "Culture and Panic Disorder" explores how the psychiatric
classification of panic disorder first emerged, how medical
theories of this disorder have shifted through time, and whether or
not panic disorder can actually be diagnosed across cultures.
In this breakthrough volume a distinguished group of medical and
psychological anthropologists, psychiatrists, psychologists, and
historians of science provide ethnographic insights as they
investigate the presentation and generation of panic disorder in
various cultures. The first available work with a focus on the
historical and cross-cultural aspects of panic disorders, this book
presents a fresh opportunity to reevaluate Western theories of
panic that were formerly taken for granted.
Since the 1970s, understanding of the effects of trauma, including
flashbacks and withdrawal, has become widespread in the United
States. As a result Americans can now claim that the phrase
posttraumatic stress disorder (PTSD) is familiar even if the
American Psychiatric Association's criteria for diagnosis are not.
As embedded as these ideas now are in the American mindset,
however, they are more widely applicable, this volume attempts to
show, than is generally recognized. The essays in Culture and PTSD
trace how trauma and its effects vary across historical and
cultural contexts. Culture and PTSD examines the applicability of
PTSD to other cultural contexts and details local responses to
trauma and the extent they vary from PTSD as defined in the
American Psychiatric Association's Diagnostic and Statistical
Manual. Investigating responses in Peru, Indonesia, Haiti, and
Native American communities as well as among combat veterans,
domestic abuse victims, and adolescents, contributors attempt to
address whether PTSD symptoms are present and, if so, whether they
are a salient part of local responses to trauma. Moreover, the
authors explore other important aspects of the local presentation
and experience of trauma-related disorder, whether the Western
concept of PTSD is known to lay members of society, and how the
introduction of PTSD shapes local understandings and the course of
trauma-related disorders. By attempting to determine whether
treatments developed for those suffering PTSD in American and
European contexts are effective in global settings of violence or
disaster, Culture and PTSD questions the efficacy of international
responses that focus on trauma. Contributors: Carmela Alcantara,
Tom Ball, James K. Boehnlein, Naomi Breslau, Whitney Duncan, Byron
J. Good, Mary-Jo DelVecchio Good, Jesse H. Grayman, Bridget M.
Haas, Devon E. Hinton, Erica James, Janis H. Jenkins, Hanna
Kienzler, Brandon Kohrt, Roberto Lewis-Fernandez, Richard J.
McNally, Theresa D. O'Nell, Duncan Pedersen, Nawaraj Upadhaya,
Carol M. Worthman, Allan Young.
Since the 1970s, understanding of the effects of trauma, including
flashbacks and withdrawal, has become widespread in the United
States. As a result Americans can now claim that the phrase
posttraumatic stress disorder (PTSD) is familiar even if the
American Psychiatric Association's criteria for diagnosis are not.
As embedded as these ideas now are in the American mindset,
however, they are more widely applicable, this volume attempts to
show, than is generally recognized. The essays in Culture and PTSD
trace how trauma and its effects vary across historical and
cultural contexts. Culture and PTSD examines the applicability of
PTSD to other cultural contexts and details local responses to
trauma and the extent they vary from PTSD as defined in the
American Psychiatric Association's Diagnostic and Statistical
Manual. Investigating responses in Peru, Indonesia, Haiti, and
Native American communities as well as among combat veterans,
domestic abuse victims, and adolescents, contributors attempt to
address whether PTSD symptoms are present and, if so, whether they
are a salient part of local responses to trauma. Moreover, the
authors explore other important aspects of the local presentation
and experience of trauma-related disorder, whether the Western
concept of PTSD is known to lay members of society, and how the
introduction of PTSD shapes local understandings and the course of
trauma-related disorders. By attempting to determine whether
treatments developed for those suffering PTSD in American and
European contexts are effective in global settings of violence or
disaster, Culture and PTSD questions the efficacy of international
responses that focus on trauma. Contributors: Carmela Alcantara,
Tom Ball, James K. Boehnlein, Naomi Breslau, Whitney Duncan, Byron
J. Good, Mary-Jo DelVecchio Good, Jesse H. Grayman, Bridget M.
Haas, Devon E. Hinton, Erica James, Janis H. Jenkins, Hanna
Kienzler, Brandon Kohrt, Roberto Lewis-Fernandez, Richard J.
McNally, Theresa D. O'Nell, Duncan Pedersen, Nawaraj Upadhaya,
Carol M. Worthman, Allan Young.
Psychiatric classifications created in one culture may not be as
universal as we assume, and it is difficult to determine the
validity of a classification even in the culture in which it was
created. "Culture and Panic Disorder" explores how the psychiatric
classification of panic disorder first emerged, how medical
theories of this disorder have shifted through time, and whether or
not panic disorder can actually be diagnosed across cultures.
In this breakthrough volume a distinguished group of medical and
psychological anthropologists, psychiatrists, psychologists, and
historians of science provide ethnographic insights as they
investigate the presentation and generation of panic disorder in
various cultures. The first available work with a focus on the
historical and cross-cultural aspects of panic disorders, this book
presents a fresh opportunity to reevaluate Western theories of
panic that were formerly taken for granted.
Some of the most innovative and provocative work on the emotions
and illness is occurring in cross-cultural research on depression.
Culture and Depression presents the work of anthropologists,
psychiatrists, and psychologists who examine the controversies,
agreements, and conceptual and methodological problems that arise
in the course of such research. A book of enormous depth and
breadth of discussion, Culture and Depression enriches the
cross-cultural study of emotions and mental illness and leads it in
new directions. It commences with a historical study followed by a
series of anthropological accounts that examine the problems that
arise when depression is assessed in other cultures. This is a work
of impressive scholarship which demonstrates that anthropological
approaches to affect and illness raise central questions for
psychiatry and psychology, and that cross-cultural studies of
depression raise equally provocative questions for anthropology.
Chronic pain challenges the central tenet of biomedicine: that
objective knowledge of the human body and mind is possible apart
from subjective experience and social context. Sufferers, finding
that chronic pain alters every aspect of life, often become
frustrated and distrust a profession seemingly unable to explain or
effectively treat their illness. The authors of this innovative
volume offer an entirely different, ethnographic approach,
searching out more effective ways to describe and analyze the human
context of pain.
How can we analyze a mode of experience that appears to the pain
sufferer as an unmediated fact of the body and is yet so resistant
to language? With case studies drawn from anthropological
investigations of chronic pain sufferers and pain clinics in the
northeastern United States, the authors explore the great divide
between the culturally shaped language of suffering and the
traditional language of medical and psychological theorizing. They
argue that the representation of experience in local social worlds
is a central challenge to the human sciences and to ethnographic
writing, and that meeting that challenge is also crucial to the
refiguring of pain in medical discourse and health policy
debates.
Anthropologists, scholars from the medical social sciences and
humanities, and many general readers will be interested in "Pain as
Human Experience," In addition, behavioral medicine and pain
specialists, psychiatrists, and primary care practitioners will
find much that is relevant to their work in this book.
Medicine supposedly offers a scientific account of the human body and of illness, and it follows that scientific medicine treats all forms of folk medicine as little more than superstitious practices. Professor Good argues that this impoverished perspective neglects many facets of Western medical practice and obscures its kinship with healing in other traditions. Drawing on his own anthropological research in America and the Middle East, his analysis of illness and medicine explores the role of cultural factors in the experience of illness and the practice of medicine.
Biomedicine is often thought to provide a scientific account of the
human body and of illness. In this view, non-Western and folk
medical systems are regarded as systems of 'belief' and subtly
discounted. This is an impoverished perspective for understanding
illness and healing across cultures, one that neglects many facets
of Western medical practice and obscures its kinship with healing
in other traditions. Drawing on his research in several American
and Middle Eastern medical settings, in this 1993 book Professor
Good develops a critical, anthropological account of medical
knowledge and practice. He shows how physicians and healers enter
and inhabit distinctive worlds of meaning and experience. He
explores how stories or illness narratives are joined with bodily
experience in shaping and responding to human suffering and argues
that moral and aesthetic considerations are present in routine
medical practice as in other forms of healing.
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