Our Most Troubling Madness: Case Studies in Schizophrenia across Cultures (Volume 11) (Ethnographic Studies in Subjectivity)

This book examines the way schizophrenia is shaped by its social context: how life is lived with this madness in different settings, and what it is about those settings that alters the course of the illness, its outcome, and even the structure of its symptoms. Until recently, schizophrenia was perhaps our best example—our poster child—for the “bio-bio-bio” model of psychiatric illness: genetic cause, brain alteration, pharmacologic treatment. We now have direct epidemiological evidence that people are more likely to fall ill with schizophrenia in some social settings than in others, and more likely to recover in some social settings than in others. Something about the social world gets under the skin. This book presents twelve case studies written by psychiatric anthropologists that help to illustrate some of the variability in the social experience of schizophrenia and that illustrate the main hypotheses about the different experience of schizophrenia in the west and outside the west--and in particular, why schizophrenia seems to have a more benign course and outcome in India. We argue that above all it is the experience of “social defeat” that increases the risk and burden of schizophrenia, and that opportunities for social defeat are more abundant in the modern west. There is a new role for anthropology in the science of schizophrenia. Psychiatric science has learned—epidemiologically, empirically, quantitatively—that our social world makes a difference. But the highly structured, specific-variable analytic methods of standard psychiatric science cannot tell us what it is about culture that has that impact. The careful observation enabled by rich ethnography allows us to see in more detail what kinds of social and cultural features may make a difference to a life lived with schizophrenia. And if we understand culture’s impact more deeply, we believe that we may improve the way we reach out to help those who struggle with our most troubling madness. Schizophrenia Has Long Puzzled Researchers In The Fields Of Psychiatric Medicine And Anthropology. Why Is It That The Rates Of Developing Schizophrenia--long The Poster Child For The Biomedical Model Of Psychiatric Illness--are Low In Some Countries And Not In Others? And Why Do Migrants To Western Countries Find That They Are At Higher Risk For This Disease When They Arrive? T.m. Luhrmann And Jocelyn Marrow Argue It Is Because The Root Causes For Schizophrenia Are Not Only Biological, But Also Sociocultural. This Book Gives An Intimate, Personal Account Of Those Living With Serious Psychotic Disorder In The U.s., India, Africa, And Southeast Asia. It Introduces The Notion That Social Defeat--the Physical Or Symbolic Defeat Of One Person By Another--is A Core Mechanism In The Increased Risk For Psychotic Illness. Furthermore, 'care As Usual' As It Occurs In The U.s. Actually Increases The Likelihood Of Social Defeat, Whereas 'care As Usual' In A Country Like India Diminishes It--provided By Publisher. I'm Schizophrenic! How Diagnosis Can Change Identity In The U.s. / T.m. Luhrmann -- Diagnostic Neutrality In Psychiatric Treatment In North India / Amy June Sousa -- Vulnerable Transition In A World Of Kin : In The Shadow Of Good Wifeliness In North India / Jocelyn Marrow -- Work And Respect In Chennai / Giulia Mazza -- Racism And Immigration : An African-caribbean Woman In London / Johanne Eliacin -- Voices That Are More Benign : The Experience Of Auditory Hallucinations In Chennai / T.m. Luhrmann And R. Padmavati -- Demonic Voices : One Man's Experience Of God And Witches In Accra, Ghana / Damien Droney -- Madness Experienced As Faith : Temple Healing In South India / Anubha Sood -- Faith Interpreted As Madness : Religion, Poverty, And Psychiatry In The Life Of A Romanian Woman / Jack Friedman -- The Culture Of The Institutional Circuit In The United States / T.m. Luhrmann -- Return To Baseline : A Different Kind Of Psychosis In Thailand / Julia Cassaniti -- A Fragile Recovery In The United States / Neely Myers. Edited By T.m. Luhrmann And Jocelyn Marrow. Includes Bibliographical References And Index. Schizophrenia has long puzzled researchers in the fields of psychiatric medicine and anthropology.  Why is it that the rates of developing schizophrenia—long the poster child for the biomedical model of psychiatric illness—are low in some countries and higher in others? And why do migrants to Western countries find that they are at higher risk for this disease after they arrive? T. M. Luhrmann and Jocelyn Marrow argue that the root causes of schizophrenia are not only biological, but also sociocultural.
 
This book gives an intimate, personal account of those living with serious psychotic disorder in the United States, India, Africa, and Southeast Asia. It introduces the notion that social defeat—the physical or symbolic defeat of one person by another—is a core mechanism in the increased risk for psychotic illness. Furthermore, “care-as-usual” treatment as it occurs in the United States actually increases the likelihood of social defeat, while “care-as-usual” treatment in a country like India diminishes it. ix xi x xv 1 "I'm Schizophrenic!": How Diagnosis Can Change Identity in the United States by T.M. Luhrmann Diagnostic Neutrality in Psychiatric Treatment in North India by Amy June Sousa Vulnerable Transitions in a World of Kin: In the Shadow of Good Wifeliness in North India by Jocelyn Marrow Work and Respect in Chennai by Giulia Mazza Racism and Immigration: An African-Caribbean Woman in London by Johanne Eliacin Voices That Are More Benign: The Experience of Auditory Hallucinations n Chennai by T. M. Luhrmann and R. Padmavati Demonic Voices: One Man's Experience of God, Witches, and Psychosis in Accra, Ghana by Damien Droney Madness Experienced as Faith: Temple Healing in North India by Anubha Sood Faith Interpreted as Madness: Religion, Poverty, and Psychiatry in the Life of a Romanian Woman by Jack R. Friedman The Culture of the Institutional Circuit in the United States by T.M. Luhrmann Return to Bas4eline: A WOman wiht Acute-Onset, Non-affective Remitting Psychosis in Thailand by Julia Cassaniti A Fragile Recovery in the United States by Neely A. L. Myers 197 223 241 265 269 La 4e de couverture indique : "Schizophrenia has long puzzled researchers in the fields of psychiatric medicine and anthropology. Why is it that the rates of developing schizophrenia--long the poster child for the biomedical model of psychiatric illness--are low in some countries and not in others? And why do migrants to Western countries find that they are at higher risk for this disease when they arrive? T.M. Luhrmann and Jocelyn Marrow argue it is because the root causes for schizophrenia are not only biological, but also sociocultural. This book gives an intimate, personal account of those living with serious psychotic disorder in the U.S., India, Africa, and Southeast Asia. It introduces the notion that social defeat--the physical or symbolic defeat of one person by another--is a core mechanism in the increased risk for psychotic illness. Furthermore, 'care as usual' as it occurs in the U.S. actually increases the likelihood of social defeat, whereas 'care as usual' in a country like India diminishes it." Schizophrenia has long puzzled researchers in the fields of psychiatric medicine and anthropology. Why is it that the rates of developing schizophrenia—long the poster child for the biomedical model of psychiatric illness—are low in some countries and higher in others? And why do migrants to Western countries find that they are at higher risk for this disease after they arrive? T. M. Luhrmann and Jocelyn Marrow argue that the root causes of schizophrenia are not only biological, but also sociocultural. This book gives an intimate, personal account of those living with serious psychotic disorder in the United States, India, Africa, and Southeast Asia. It introduces the notion that social defeat—the physical or symbolic defeat of one person by another—is a core mechanism in the increased risk for psychotic illness. Furthermore, “care-as-usual” treatment as it occurs in the United States actually increases the likelihood of social defeat, while “care-as-usual” treatment in a country like India diminishes it. CONTENTS ILLUSTRATIONS FOREWORD ACKNOWLEDGMENTS Introduction 1. “I’m Schizophrenic!”: How Diagnosis Can Change Identity in the United States 2. Diagnostic Neutrality in Psychiatric Treatment in North India 3. Vulnerable Transitions in a World of Kin: In the Shadow of Good Wifeliness in North India 4. Work and Respect in Chennai 5. Racism and Immigration: An African-Caribbean Woman in London 6. Voices Th at Are More Benign: The Experience of Auditory Hallucinations in Chennai 7. Demonic Voices: One Man’s Experience of God, Witches, and Psychosis in Accra, Ghana 8. Madness Experienced as Faith: Temple Healing in North India 9. Faith Interpreted as Madness: Religion, Poverty, and Psychiatry in the Life of a Romanian Woman 10. The Culture of the Institutional Circuit in the United States 11. Return to Baseline: A Woman with Acute-Onset, Non-aff ective Remitting Psychosis in Thailand 12. A Fragile Recovery in the United States Conclusion NOTES BIBLIOGRAPHY CONTRIBUTORS INDEX This work examines the way schizophrenia is shaped by its social context: how life is lived with this madness in different settings, and what it is about those settings that alters the course of the illness, its outcome, and even the structure of its symptoms