Cambridge Studies in Medical Anthropology

380 Pages·2003·1.49 MB·English

P1:FpQ
FM Jenkins&Barrett 0521829550 September5,2003 7:8
Schizophrenia, Culture, and Subjectivity
Cambridge Studies in Medical Anthropology 11
This volume brings together a number of the foremost scholars –
anthropologists, psychiatrists, psychologists, and historians – currently
studying schizophrenia, its subjective dimensions, and the cultural pro-
cesses through which these are experienced. Based on research un-
dertaken in Australia, Bangladesh, Borneo, Canada, Colombia, India,
Indonesia,Nigeria,theUnitedStates,andZanzibar,italsoincorporates
a critical analysis of World Health Organization cross-cultural findings.
Contributors share an interest in subjective and interpretive aspects of
illness, but all work with a concept of schizophrenia that addresses its
biologicaldimensions.Thevolumeisofinteresttoscholarsinthesocial
andhumansciencesforthetheoreticalattentiongiventotherelationship
between culture and subjectivity. Multidisciplinary in design, it is writ-
teninastyleaccessibletoadiversereadership,includingundergraduate
students.Itisofpracticalrelevancenotonlytopsychiatrists,butalsoto
all mental health professionals who encounter, day to day, the clinical
problemsarisingattheinterfaceofcultureandpsychosis.
JanisHunterJenkins,ProfessorofAnthropologyandPsychiatryatCase
Western Reserve University, is Principal Investigator for an NIMH-
sponsored study of the subjective experiences of recovery among per-
sons taking atypical antipsychotic medications. Professor Jenkins has
publishedwidelyintheBritishJournalofPsychiatry,AmericanJournalof
Psychiatry,Culture,MedicineandPsychiatry,andTransculturalPsychiatry,
as well as in anthropological journals such as Ethos and Medical Anthro-
pologyQuarterly.
Robert John Barrett is Professor of Psychiatry at the University of
Adelaide and Clinical Advisor to the Psychiatric Services of the Royal
Adelaide Hospital. Professor Barrett has published in cross-disciplinary
journals such as Culture, Medicine and Psychiatry, and Social Science and
Medicine,aswellasinanthropologicaljournalssuchasMan.Hismono-
graph, The Psychiatric Team and the Social Definition of Schizophrenia
(1996), was published in the Cambridge University Press series Stud-
iesinSocialandCommunityPsychiatry.
i
P1:FpQ
FM Jenkins&Barrett 0521829550 September5,2003 7:8
ii
P1:FpQ
FM Jenkins&Barrett 0521829550 September5,2003 7:8
CambridgeStudiesinMedicalAnthropology
Editor
ALANHARWOOD UniversityofMassachusetts,Boston
EditorialBoard
WILLIAMDRESSLER UniversityofAlabama
RONALDFRANKENBERG BrunelUniversity,UK
MARYJOGOOD HarvardUniversity
SHARONKAUFMAN UniversityofCalifornia,SanFrancisco
SHIRLEYLINDENBAUM CityUniversityofNewYork
MARGARETLOCK McGillUniversity
CATHERINEPANTER-BRICK UniversityofDurham,UK
Medical anthropology is the fastest growing specialist area within an-
thropology,inbothNorthAmericaandEurope.Beginningasanapplied
fieldservingpublichealthspecialists,medicalanthropologynowprovides
asignificantforumformanyofthemosturgentdebatesinanthropology
and the humanities. It includes the study of medical institutions and
healthcareinavarietyofrichandpoorsocieties,theinvestigationofthe
culturalconstructionofillness,andtheanalysisofideasaboutthebody,
birth,maturity,aging,anddeath.
Thisseriesincludestheoreticallyinnovativemonographsandstate-of-
the-artcollectionsofessaysoncurrentissues.
1 Lynn M. Morgan, Community Participation in Health: The Politics of
PrimaryCareinCostaRica
2 ThomasJ.Csordas(ed.), EmbodimentandExperience:TheExistential
GroundofCultureandHealth
3 PaulBrodwin, MedicineandMoralityinHaiti:TheContestforHealing
Power
4 SusanReynoldsWhyte, QuestioningMisfortune:ThePragmaticsofUn-
certaintyinEasternUganda
5 Margaret Lock and Patricia Kaufert, Pragmatic Women and Body
Politics
6 VincanneAdams, DoctorsforDemocracy
7 ElizabethHsu, TheTransmissionofChineseMedicine
Seriesinformationcontinuesaftertheindex.
iii
P1:FpQ
FM Jenkins&Barrett 0521829550 September5,2003 7:8
iv
P1:FpQ
FM Jenkins&Barrett 0521829550 September5,2003 7:8
Schizophrenia, Culture,
and Subjectivity
The Edge of Experience
Edited by
Janis Hunter Jenkins
CaseWesternReserveUniversity
Robert John Barrett
UniversityofAdelaide
v
cambridge university press
Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo
Cambridge University Press
The Edinburgh Building, Cambridge cb2 2ru, UK
Published in the United States of America by Cambridge University Press, New York
www.cambridge.org
Information on this title: www.cambridge.org/9780521829557
© Cambridge University Press 2004
This publication is in copyright. Subject to statutory exception and to the provision of
relevant collective licensing agreements, no reproduction of any part may take place
without the written permission of Cambridge University Press.
First published in print format 2004
isbn-13 978-0-511-16574-0 eBook (NetLibrary)
isbn-10 0-511-16574-9
eBook (NetLibrary)
isbn-13 978-0-521-82955-7 hardback
isbn-10 0-521-82955-0 hardback
isbn-13 978-0-521-53641-7 paperback
isbn-10 0-521-53641-3 paperback
Cambridge University Press has no responsibility for the persistence or accuracy of urls
for external or third-party internet websites referred to in this publication, and does not
guarantee that any content on such websites is, or will remain, accurate or appropriate.
P1:FpQ
FM Jenkins&Barrett 0521829550 September5,2003 7:8
Contents
Contributors page ix
Preface
 
xv
Acknowledgments xix
Introduction
   
  
1
Part1: Culture,Self,andExperience
1 SchizophreniaasaParadigmCaseforUnderstanding
FundamentalHumanProcesses
  
29
2 InterrogatingtheMeaningof“Culture”intheWHO
InternationalStudiesofSchizophrenia
 
62
3 KurtSchneiderinBorneo:DoFirstRankSymptomsApply
totheIban?
  
87
4 LivingThroughaStaggeringWorld:ThePlayofSignifiers
inEarlyPsychosisinSouthIndia
 ,  , 
 
110
5 InandOutofCulture:EthnographicMeanstoInterpreting
Schizophrenia
 
146
vii
P1:FpQ
FM Jenkins&Barrett 0521829550 September5,2003 7:8
viii Contents
Part2: FourApproachesforInvestigatingtheExperience
ofSchizophrenia
6 ExperiencesofPsychosisinJavaneseCulture:Reflectionsona
CaseofAcute,RecurrentPsychosisinContemporary
Yogyakarta,Indonesia
 .   . . 
167
7 To“SpeakBeautifully”inBangladesh:Subjectivityas
Pa¯gala¯mi
 . , .
196
8 InnovativeCarefortheHomelessMentallyIll
inBogota,Colombia
 ,  , 
 . 
219
9 SymptomsofColonialism:ContentandContextofDelusion
inSouthwestNigeria,1945–1960
 
238
Part3: SubjectivityandEmotion
10 MadnessinZanzibar:AnExplorationofLivedExperience
 . 
255
11 Subject/SubjectivitiesinDispute:ThePoetics,Politics,
andPerformanceofFirst-PersonNarratives
ofPeoplewithSchizophrenia
 . 
282
12 “NegativeSymptoms,”Commonsense,andCultural
DisembeddingintheModernAge
 . 
303
13 SubjectiveExperienceofEmotioninSchizophrenia
 .    . 
329
Index 349
P1:FpQ
FM Jenkins&Barrett 0521829550 September5,2003 7:8
Contributors
Robert John Barrett is a psychiatrist and anthropologist and Professor
of Psychiatry at the University of Adelaide. His clinical training was in
medicine and psychiatry. He received a Ph.D. from the University of
AdelaideinanthropologyandundertookpostdoctoralstudiesatHarvard
University. His earlier research was in the field of psychiatric hospital
ethnography, and he is currently working on ethnographic and clinical
studiesconductedamongtheIbaninBorneo.
EllenCorinisapsychologistandProfessorofAnthropologyandPsychi-
atry at McGill University and researcher at the Psychosocial Research
Division, Douglas Hospital Research Centre. She received a Ph.D. in
psychology from the Universite´ de Louvain, Belgium. Her research in
Central Africa, Quebec, and currently in India focuses on the interface
betweencultureandsubjectivity.Hercurrentworkdealswithpsychosis
andculture.SheisalsoamemberoftheCanadianPsychoanalyticSociety
andaclinicalpractitioner.
EsperanzaDiazisapsychiatristandAssociateProfessorofPsychiatryand
MedicalDirectoroftheHispanicClinicattheYaleUniversitySchoolof
Medicine.ShewaseducatedatJaverianaUniversityinBogota,Colombia,
and Yale University. She is working on a project following medica-
tion adherence for Latinos collecting quantitative and qualitative data.
The purpose is to identify ethnic differences in medication adherence
between Latinos and non-Latinos. She is interested in health services
research.
Sue E. Estroff is an anthropologist and Professor of Social Medicine at
theUniversityofNorthCarolinaatChapelHill.Shedidherundergrad-
uate work at Duke University and her graduate studies in anthropology
attheUniversityofWisconsin–Madison,whereshewasalsoapostdoc-
toralFellowinpsychiatry.Shehasstudiedpeoplewithschizophreniaand
otherseverepsychiatricdisordersinseveralsettingsintheUnitedStates
ix