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Patients and healers in the context of culture: an exploration of the borderland between anthropology, medicine, and psychiatry describes observations of clinical interviews between various medical practitioners, namely folk healers, temple medicine men, and Chinese style and Western style physicians, and their patients. It stresses the importance of adopting proper cultural perspectives, making one's interpretations within that framework, and relying on direct observation; and urges an integration of social and cultural methods into the routine training of doctors, so as to enable a more humane and appropriate clinical practice. Medical anthropology is rich with anecdote and description focused on one or another aspect of patients or diseases, practitioners or healing, symbolisms or religion. This book takes us beyond such details and provides an integrating theoretical framework, operational models, and a systematic methodology of study that will allow the clinician and investigator to avoid the quagmires of ethnocentricity and reductionist formulation. The material is based on ten years of comparative cross-cultural research of Chinese medical systems at the National Taiwan University, Harvard University, the University of Washington, and the National Institutes of Health.
From the Preface, by Arthur Kleinman: Patients and Healers in the Context of Culture presents a theoretical framework for studying the relationship between medicine, psychiatry, and culture. That framework is principally illustrated by materials gathered in field research in Taiwan and, to a lesser extent, from materials gathered in similar research in Boston. The reader will find this book contains a dialectical tension between two reciprocally related orientations: it is both a cross-cultural (largely anthropological) perspective on the essential components of clinical care and a clinical perspective on anthropological studies of medicine and psychiatry. That dialectic is embodied in my own academic training and professional life, so that this book is a personal statement. I am a psychiatrist trained in anthropology. I have worked in library, field, and clinic on problems concerning medicine and psychiatry in Chinese culture. I teach cross-cultural psychiatry and medical anthropology, but I also practice and teach consultation psychiatry and take a clinical approach to my major cross-cultural teaching and research involvements. The theoretical framework elaborated in this book has been applied to all of those areas; in turn, they are used to illustrate the theory. Both the theory and its application embody the same dialectic. The purpose of this book is to advance both poles of that dialectic: to demonstrate the critical role of social science (especially anthropology and cross-cultural studies) in clinical medicine and psychiatry and to encourage study of clinical problems by anthropologists and other investigators involved in cross-cultural research. This title is part of UC Press's Voices Revived program, which commemorates University of California Press's mission to seek out and cultivate the brightest minds and give them voice, reach, and impact. Drawing on a backlist dating to 1893, Voices Revived makes high-quality, peer-reviewed scholarship accessible once again using print-on-demand technology. This title was originally published in 1980. From the Preface, by Arthur Kleinman: Patients and Healers in the Context of Culture presents a theoretical framework for studying the relationship between medicine, psychiatry, and culture. That framework is principally illustrated by materials gathered
Kleinman, a psychiatrist, trained in anthropology, reports on his studies of health care in Taiwan. He describes his observations of clinical interviews between various medical practitioner, folk-healers, temple medicine men, and Chinese-style and Western-style physicians and their patients. He stress the importance of adopting the proper cultural perspective, making ones interpretations within that framework.
One of the most influential and creative scholars in medical anthropology takes stock of his recent intellectual odysseys in this collection of essays. Arthur Kleinman, an anthropologist and psychiatrist who has studied in Taiwan, China, and North America since 1968, draws upon his bicultural, multidisciplinary background to propose alternative strategies for thinking about how, in the postmodern world, the social and medical relate. Writing at the Margin explores the border between medical and social problems, the boundary between health and social change. Kleinman studies the body as the mediator between individual and collective experience, finding that many health problems—for example the trauma of violence or depression in the course of chronic pain—are less individual medical problems than interpersonal experiences of social suffering. He argues for an ethnographic approach to moral practice in medicine, one that embraces the infrapolitical context of illness, the responses to it, the social institutions relating to it, and the way it is configured in medical ethics. Previously published in various journals, these essays have been revised, updated, and brought together with an introduction, an essay on violence and the politics of post-traumatic stress disorder, and a new chapter that examines the contemporary ethnographic literature of medical anthropology.
An invaluable guide to becoming a competent and compassionate physician. Medical students and physicians-in-training embark on a long journey that, although steeped in scientific learning and technical skill building, includes little guidance on the emotional and interpersonal dimensions of becoming a healer. Written for anyone in the health care community who hopes to grow emotionally and cognitively in the way they interact with patients, On Becoming a Healer explains how to foster doctor-patient relationships that are mutually nourishing. Dr. Saul J. Weiner, a physician-educator, argues that joy in medicine requires more than idealistic aspirations—it demands a capacity to see past the "otherness" that separates the well from the sick, the professional in a white coat from the disheveled patient in a hospital gown. Weiner scrutinizes the medical school indoctrination process and explains how it molds the physician's mindset into that of a task completer rather than a thoughtful professional. Taking a personal approach, Weiner describes his own journey to becoming an internist and pediatrician while offering concrete advice on how to take stock of your current development as a physician, how to openly and fully engage with patients, and how to establish clear boundaries that help defuse emotionally charged situations. Readers will learn how to counter judgmentalism, how to make medical decisions that take into account the whole patient, and how to incorporate the organizing principle of healing into their practice. Each chapter ends with questions for reflection and discussion to help personalize the lessons for individual learners.
Through arresting narratives we meet a woman aiding refugees in sub-Saharan Africa, facing the chaos of a meaningless society and a doctor trying to stay alive during Mao's cultural revolution - individuals challenged by their societies and caught up in existential moral experiences that define what it means to be human.
"This is a terrific book―moving, clear, and compassionate. It not only illustrates the way psychiatric illness is shaped by culture, but also suggests that social environments can be used to improve the course and outcome of the illness. Well worth reading." — T. M. Luhrmann, author of Of Two Minds: An Anthropologist looks at American Psychiatry Bethel House, located in a small fishing village in northern Japan, was founded in 1984 as an intentional community for people with schizophrenia and other psychiatric disorders. Using a unique, community approach to psychosocial recovery, Bethel House focuses as much on social integration as on therapeutic work. As a centerpiece of this approach, Bethel House started its own businesses in order to create employment and socialization opportunities for its residents and to change public attitudes toward the mentally ill, but also quite unintentionally provided a significant boost to the distressed local economy. Through its work programs, communal living, and close relationship between hospital and town, Bethel has been remarkably successful in carefully reintegrating its members into Japanese society. It has become known as a model alternative to long-term institutionalization. In A Disability of the Soul, Karen Nakamura explores how the members of this unique community struggle with their lives, their illnesses, and the meaning of community. Told through engaging historical narrative, insightful ethnographic vignettes, and compelling life stories, her account of Bethel House depicts its achievements and setbacks, its promises and limitations. A Disability of the Soul is a sensitive and multidimensional portrait of what it means to live with mental illness in contemporary Japan.
With Inclusion, Steven Epstein argues that strategies to achieve diversity in medical research mask deeper problems, ones that might require a different approach and different solutions. Formal concern with this issue, Epstein shows, is a fairly recent phenomenon. Until the mid-1980s, scientists often studied groups of white, middle-aged men - and assumed that conclusions drawn from studying them would apply to the rest of the population. But struggles involving advocacy groups, experts, and Congress led to reforms that forced researchers to diversify the population from which they drew for clinical research. While the prominence of these inclusive practices has offered hope to traditionally underserved groups, Epstein argues that it has drawn attention away from the tremendous inequalities in health that are rooted not in biology but in society. This edition is in two volumes. The second volume ISBN is 9781458732194.
This is the definitive textbook on global mental health, an emerging priority discipline within global health, which places priority on improving mental health and achieving equity in mental health for all people worldwide.
In the last few years there has been a great revival of interest in culture-bound psychiatric syndromes. A spate of new papers has been published on well known and less familiar syndromes, and there have been a number of attempts to put some order into the field of inquiry. In a review of the literature on culture-bound syndromes up to 1969 Yap made certain suggestions for organizing thinking about them which for the most part have not received general acceptance (see Carr, this volume, p. 199). Through the seventies new descriptive and conceptual work was scarce, but in the last few years books and papers discussing the field were authored or edited by Tseng and McDermott (1981), AI-Issa (1982), Friedman and Faguet (1982) and Murphy (1982). In 1983 Favazza summarized his understanding of the state of current thinking for the fourth edition of the Comprehensive Textbook of Psychiatry, and a symposium on culture-bound syndromes was organized by Kenny for the Eighth International Congress of Anthropology and Ethnology. The strong est impression to emerge from all this recent work is that there is no substantive consensus, and that the very concept, "culture-bound syndrome" could well use some serious reconsideration. As the role of culture-specific beliefs and prac tices in all affliction has come to be increasingly recognized it has become less and less clear what sets the culture-bound syndromes apart.