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cartesian dualism (The Three Bodies by Scheper-Hughes and Lock)
the artificial separation of mind and body
Descartes argued have 2 essential parts: the physical party and the immaterial mind or soul
be believed that the mind controlled the body from a tiny bland in the brain, pineal gland
Descartes placed the soul in the pineal gland, allowing it to guide the body’s actions like rider on a horse
This separation of mind and body allowed science to focus on the physical aspects of life, while the soul remained in the realm of theology
Complementary dualism (The Three Bodies by Scheper-Hughes and Lock)
different parts work together harmoniously to create a whole
these parts could be various elements, objects, concepts, or components that are
in this case, the focus is how the parts relate to the entire system, not how they oppose each other
Herculine Barbin (The Three Bodies by Scheper-Hughes and Lock)
At that time it was the opinion of medical science in Europe that nature produced in humans (unlike other animals) only 2 biological sexes.
the diary of Herculine Barbin, a 19th century French hermaphrodite: Once discovered to be sexually ambiguous, Herculine was forced to sex and gender transformation based on her deviant sexual preference for female partners
Although fully socialized to a healthy personal and social identity as an adult female, Herculine was forced to accept a medical diagnosis of her “true” sex as male, which resulted in her suicide a few years later
Dr. Samuel Cartwright and Drapetomania (The Three Bodies by Scheper-Hughes and Lock)
Dr. Samuel Cartwright coined the term drapetomania to describe the disease of the mind that “induces the negro to run away from service".
The physician reassured that with proper medical advice, strictly followed, this troublesome practice can be entirely prevented
What are the three bodies? (The Three Bodies by Scheper-Hughes and Lock)
individual body, social body, body politic
individual body (The Three Bodies by Scheper-Hughes and Lock)
a given, biopsychological existential reality; refers to the processes of becoming and being a person, an embodied self
this “individual” body—conceived as the center of perceiving, experiencing, and thinking world—is always mediated through collective cultural meanings
The body is proof of one’s existence. it is through the body and its sensory and perceptual circuits that we are able to experience and differentiate among other objects and things in the world
social body (The Three Bodies by Scheper-Hughes and Lock)
referring to the representational uses of the body as a natural symbol with which to think about nature, social, and cultural (as Mary Douglas suggested)
The body is a symbol- a site of constant exchange of meaning between natural and social worlds
the body in health offers a model of organic wholeness, while the body in sickness offers a model of social disharmony, conflict, and disintegration
ex: “Thatcher was at the head of the government.” We are drawing on a shared symbolic understanding of the head in relation to other parts of the body
ex: Needham pointed out some of the frequently occurring associations to right- and left-handedness, especially the symbolic equations, on the one hand, between the left and that which is inferior, dark, dirty, and female, and, on the other hand, between the right and that which is superior, holy, light, dominant, and male. Needham called attention to such uses of the body as a convenient means of justifying particular social values and social arrangements, such as the “natural” dominance of males over females. His point is that these common symbolic equations are not so much natural as they are useful, at least to those “on the top” and to the right.
body politic (The Three Bodies by Scheper-Hughes and Lock)
refers to the regulation, surveillance, and control of bodies (individual and collective) in reproduction and sexuality, in work and in leisure, in sickness and other forms of deviance and sexual difference
political institutions distinguish the “normative” and “deviant” behavior to control the individual body and regulate the control body. Biomedicine is often served the interest of the state.
ex: There are many types of polity, ranging from acephlous anachy of “simple” foraging societies, in which deviants may be punished by total social ostracism and consequently by death through chieftainships, monarchies, oligarchies, democracies, and modern totalitarian states
in all of these policies, the stability of the body politic rests on its ability to regulate populations (social body) and to discipline individual bodies
What role does emotion play in the construction of the Three Bodies?
Individual Body → Emotions significantly influence how individuals experience their own bodies, illness, and pain. Emotions can shape an individual’s perception of their health, well-being, and suffering. For example, the way someone experiences pain or illness is not just a physical sensation but is also deeply affected by their emotional state. Emotions can influence whether someone seeks medical help, how they cope with their condition, and their overall well-being
Social Body → Emotions are projected onto the social body, which represents the collective emotions and sentiments of a community or society. The authors argue that social anthropologists have traditionally focused on formal, ritualized, and public emotions. However, they suggest that even more private and idiosyncratic emotions are shaped by cultural influences. This implies that emotions are not solely individual experiences but are also influenced by cultural norms, values, and expectations.
Body Politic → Emotions are also projected onto the body politic, which represents the collective emotions and sentiments of a political or societal group. The way emotions are expressed and managed at a societal level can impact political decisions, policies, and the functioning of the body politic. For example, public outrage or fear can drive political movements and influence government actions.
The authors argue against a strict division between cultural sentiments and natural passions, suggesting that emotions are always culturally shaped and imbued with cultural meaning. Emotions, in their view, bridge the gap between the mind and body, as well as between the individual and society. They are seen as a crucial “missing link” that helps to understand the intricate relationship between these aspects of human existence
Ethnomedicine (Healing Lessons from Ethnomedicine)
the study of the medical systems or healing practices of a cultural group (past or contemporary), the comparison of such systems, and increasingly the concurrent use of different ethnomedicines
for anthropologists, however, enthnomedicines are also cultural systems to be studied from the many theoretical perspectives in cultural anthropology
ethnomedicine also encompasses individual experiences—the many ways people experience and interact with ethnomedicines, talk about them, know and understand them, find meaning in them, learn and practice them, and relate to them; the social, political, and economic relations of health; the ecology of health and illness; and the interpretation of human suffering
provides us a foundation for understanding the range of ethnomedical theory and practice that can helo us to discover and understand why healing can and does occur within all ethnomedicine systems
healing v.s. curing (Healing Lessons from Ethnomedicine)
healing → restoration of physical, mental, emotional, social, and spiritual health
curing → removal, correction, or amelioration of organic pathology
examples of enthnomedicine systems (Healing Lessons from Ethnomedicine)
Traditional Chinese Medicine → One of the oldest and most well-known ethnomedicine systems. It includes practices such as acupuncture, herbal medicine, cupping therapy, and qigong. Based on the concept of balancing vital energy (qi) within the body
Ayurvedic Medicine → A traditional system of medicine that originated in India. It focuses on balancing the body’s 3 doshas (Vata, Pitta, and Kapha) through diet, herbal remedies, yoga, and other practices
Indigenous Medicine → Many indigenous cultures around the world have their own traditional healing systems. For example, Native American medicine often involves the use of medicinal plants, rituals, and ceremonies to promote healing.
How is biomedicine different from ethnomedicine? (Healing Lessons from Ethnomedicine)
medical anthropologists use the term biomedicine to refer to the traditional of scientific, biologically oriented methods of diagnosis and cure
a relatively recent tradition that is technologically sophisticated and often extremely successful in curing
historically known as allopathic medicine, the knowledge and technology of biomedicine has grown extremely quickly and, with it, the prestige and professionalization of biomedical practitioners
when viewed as a cultural system, biomedicine becomes one ethnomedicine among many other
What are the 4 major domains of disease causation? (Healing Lessons from Ethnomedicine)
The individual body (for example, genetic makeup, personality, lifestyle, emotions, nutrition, age)
the natural world (including environment, climate, toxins, natural disasters, flora and fauna, water)
the social and economic world (such as poverty, warfare, violence, social support)
the supernatural and spiritual world (for instance, God, gods, sin, witchcraft, sorcery, soul loss)
What are the 4 processes of disease? (Healing Lessons from Ethnomedicine)
imbalance (for example, humors, hot/cold, cholesterol, energy, humans with nature)
natural pathogenic processes (such as infection, degeneration)
punishment for offenses committed, wittingly or not (for instance, against nature, other people, God, spirits), and karma—the doctrine that actions have inevitable results, both good and bad, either in this life or in another incarnation
fate—preordained destiny (for example, by gods, time of birth)—or luck (being in the right or wrong place at the right or wrong time)
quesalid (The Sorcerer and His Magic)
initially a skeptic of shamanistic practices, became involved with shamans out of curiosity and the desire to expose their tricks. however, he soon found himself immersed in their world and learned their techniques
his training included a mix of pantomime, empirical knowledge, and the art of stimulating various aliments
he discovered that shamans used various methods to make their patients believe in their healing powers, such as presenting a tuft of down as a foreign body they had extracted
as he continued his apprenticeship, Quesalid realized that there were different forms of the “false supernatural” among shamans. This led hum to question the validity of various techniques and their impact on patients
He observed a competition between shamans with different methods and found himself town between the effectiveness and honesty of their practices
ultimately, he became a renowned shaman, defending the technique he had once criticized and emphasizing the importance of belief in the healing process
shaman and shamanism (The Sorcerer and His Magic)
there are 2 conditions for the balance of shamanism and its continued occurrences in society:
the structure of shamanism in a community is based on tradition and is modified overtime on an individual level. so, the public, the sorcerer, and all other elements play their part
with the shaman, the public must comply to a certain extent with the patient and the sorcerer. if the public believes the treatment will work the patient, it creates a symbolic universal closeness between the shaman, the patient, and the public
How do shamans treat and cure patients? (The Sorcerer and His Magic)
The act of spitting out the illness in the form of a “bloody worm”, which is actually a concealed tuft of down covered in blood. The shamans claim to have captured the sickness and present it to the patient and onlookers as a physical forign body that has been extracted.
The incorporation of an invisible object, representing the illness, into a headring made of bark or a bird-shaped ritual rattle. The power of the illness is believed to make these objects hang suspend in mid-air, demonstrating the shaman’s control over the sickness
Koskimo shamans spit a little saliva into their hands to represent sickness
How does biomedicine treat and cure patients? (The Sorcerer and His Magic)
Biomedicine is a scientific, evidence-based healthcare system with a focus on the physical and biochemical aspects of disease. It’s practiced by trained medical professionals and relies on standardized diagnostics and treatments.
What would their system of healing be classified as in terms of medical systems and levels of causality and why? (The Sorcerer and His Magic)
traditional or indigenous medical system
shamism operates on the belief that illness is caused by spiritual imbalances or disurbances in the spirited world
What is the interaction between belief and experience? (The Sorcerer and His Magic)
In "The Sorcerer and His Magic," the interaction between belief and experience is central to the understanding of shamanism and its effectiveness in the healing process. Belief and experience are intricately linked in the following ways:
Belief Shapes Experience: Shamanic healing relies heavily on the shaman's and the patient's beliefs in the spiritual and metaphysical aspects of health and illness. The patient's belief in the shaman's powers and the shaman's own belief in their ability to communicate with spirits and manipulate spiritual forces shape the healing experience. These shared beliefs create the framework for the rituals and treatments.
Experiential Confirmation of Belief: Shamanic practices involve various rituals, such as sucking out the "sickness" or expelling it in the form of a visible object. These rituals are experienced by both the shaman and the patient, reinforcing their shared belief in the efficacy of the treatment. When the patient perceives the presence of the "sickness" or experiences relief after a shamanic healing session, it confirms their belief in the shaman's powers and the effectiveness of the treatment.
Shamanic Power and Credibility: The shaman's reputation and effectiveness depend on their ability to provide tangible experiences to patients. When patients witness visible or felt results, their belief in the shaman's powers and the effectiveness of shamanic healing is reinforced. This, in turn, enhances the shaman's credibility and reputation in the community.
Doubt and Challenge: The interaction between belief and experience is not unidirectional. Patients, like Quesalid in the story, may challenge or doubt the legitimacy of the shamanic practices if they encounter alternative healing methods or conflicting beliefs. Doubt can lead to a reassessment of one's beliefs in the efficacy of shamanism.
placebo (Doctors and Patients: The Role of Clinicians in the Placebo Effect)
a substance of treatment that has no therapeutic effect but is given to a patient to satisfy their psychological need for treatment or to assess the impact of psychological factors on their condition
The author of this selection argues that the term placebo effect is an oxymoron because placebo means “having no effect” despite the fact that giving a patient a chemically inert medicine (the placebo) clearly can have a substantial positive outcome
How do studies use the placebo effect? (Doctors and Patients: The Role of Clinicians in the Placebo Effect)
Control groups: One group receives a placebo and the control group is used to compare the outcomes of the placebo with those of the actual treatment group
Blinding: In double-blind studies, neither the participants nor the researchers are aware of who is receiving the placebo and who is receiving the real treatment. In single-blind studies, either the participant or the researcher is unaware of the treatment allocation. This binding helps minimize bias and control for the placebo effect
Outcome measurement: Researchers assess the outcomes in both the treatment and placebo groups. By comparing the effects of the placebo with the effects of the actual treatment, they can determine the extent to which the placebo effect contributes to perceived improvements in patients.
Understanding Psychological Factors: Studies aim to understand how patients' beliefs, expectations, and psychological factors influence their responses to treatment. The placebo effect is often a result of these psychological factors, and researchers seek to quantify and analyze their impact.
Subjective Measures: Placebos are particularly relevant in studies where subjective measures are used. For example, if a study involves measuring pain relief, psychological well-being, or patient-reported outcomes, the placebo effect can significantly influence the results. Researchers use the placebo effect to understand how patient beliefs contribute to perceived benefits.
Comparative Efficacy: Researchers compare the outcomes of the placebo group with those of the treatment group. This comparison helps determine whether the actual treatment's effects are significantly superior to the effects of a placebo. It is essential to establish that the treatment provides genuine benefits beyond the placebo effect.
Quantifying the Placebo Effect: Researchers aim to quantify the magnitude of the placebo effect in a study. This helps them understand the relative contributions of the placebo response and the actual treatment to the overall observed outcomes.
Who is most likely to be affected by the placebo effect? Doctors and Patients: The Role of Clinicians in the Placebo Effect)
The placebo effect can affect a wide range of patients, but certain factors may make individuals more or less susceptible to it.
Psychological Factors: Patients who are more open to suggestion, have a positive attitude toward treatment, or believe strongly in the effectiveness of therapy are most likely to experience the placebo effect. This suggests that an indivdual’s psychological disposition plays a significant role.
Context and Expectations: The context in which treatment is provided, as well as the patient's expectations, can influence the placebo effect. Patients who have high expectations of improvement are more likely to experience positive outcomes, even if the treatment is a placebo.
Condition and Symptoms: The placebo effect may vary based on the medical condition or symptoms being treated. Some conditions or symptoms may be more responsive to placebos, while others may not show a significant response.
Clinician-Patient Relationship: The quality of the relationship between the clinician and the patient can also impact the placebo effect. A trusting and empathetic clinician-patient relationship may enhance the placebo response.
Individual Variability: People vary in their susceptibility to the placebo effect. Some individuals may consistently respond to placebos, while others may not experience any benefit.
Do physicians have any effect on the placebo effect? (Doctors and Patients: The Role of Clinicians in the Placebo Effect)
The behavior, communication, and interpersonal skills of clinicians can influence the strength of the placebo response in patients
Do sham surgeries work? Why? (Doctors and Patients: The Role of Clinicians in the Placebo Effect)
Kind of? The most important factor shaping the meaningful quality of medicine is the role of doctors. This is evident in cases where patients attribute their healing to their physicians, even in situations involving placebo or sham treatments. For example, a 76-year-old patient who underwent sham knee surgery credited his physician, Dr. Brace Moseley, for the successful outcome. The patient's belief in Dr. Moseley's skills and reputation played a pivotal role in his perceived healing, despite the sham surgery. This highlights the significant impact of doctors on patients' well-being.
What is the most important factor in determining the susceptibility of a patient to the placebo effect? (Doctors and Patients: The Role of Clinicians in the Placebo Effect)
These factors include the doctor's attitude, aptitude, enthusiasm, communication style, and the quality of the doctor-patient relationship. The text highlights that all these elements collectively play a role in shaping a patient's expectations and, consequently, their response to medical treatments, including placebos. It emphasizes the complexity of the placebo effect and the need to consider a range of factors related to both the patient and the clinician in understanding this phenomenon.
Structural violence (Structural violence and clinical medicine)
describes social structures—economic, political, legal, religious, and cultural—that stop individuals, groups, and societies from reaching their full potential
structural because they are embedded in the political and economic organization of our social world
violent because they cause injury to people
Distal and proximal interventions (Structural violence and clinical medicine)
distal interventions: performed late in the process, when patients are already sick
proximal interventions: trying to prevent the disease through efforts such as vaccinations or improved water and housing quality
PIH model (Structural violence and clinical medicine)
the model is simple: clinical and community barriers to care are removed as diagnosis and treatment are declared a public good and made available free of charge to patients living in poverty (Partners in Health)
Each patient chooses an accompagnateur, usually a neighbor, trained to deliver drugs and other supportive care in the patient’s home. Using this model, we currently provide daily supervised ART to more than 2,200 patients in rural Haiti.
This model, with conventional clinic-based (distal, situated away from the point of origin) services complemented by home-based (more proximal) care, is deemed by some to be the world’s most effective way of removing structural barriers to quality care for AIDS and other chronic diseases
it is also a way of creating jobs in rural regions in great need of them
How is AIDS treated in the Rwanda? Untied States? (Structural violence and clinical medicine)
Rwanda:
Formula-feeding instead of breastfeeding
potable water projects
Antiretroviral therapy (ART) provisions
United States:
Researchers implemented interventions and provided improvements to community care to ensure that nothing within the medical system would prevent marginalized individuals from receiving proper care
resulted in racial, gender, injection-drug use, and socioeconomic disparities almost disappearing in the community
Structural violence lessens access to adherence to effective therapy
How is structural violence enacted in HIV/AIDS treatments? (Structural violence and clinical medicine)
structural violence lessens access and adherence of effective therapy
systemic factors, such as poverty, discrimination, or unequal access to healthcare, affect the treatment and care of individuals living with HIV/AIDS
cultural competency (Anthropology in the Clinic)
a term often used in the healthcare field to acknowledge the importance of culture in clinical practice
recognizes that cultural factors significantly influence how patients are diagnosed, treated, and cared for
means being aware of more than just one culture, and how each culture has different values and beliefs
Problems with cultural competency:
suggests that culture can be reduced to a technical skill that clinicians can be trained for to develop expertise
further stereotypes in the medical field such as “Chinese say this” and “Japanese say that.”
Cultural factors do not always play a role in a case and might alter a better understanding of an episode. Instead, we use logic and reasoning
ex: A Mexican man goes to a clinic in California and he cannot make it to his next appointment not because of cultural differences but because other things in his life got in the way such as money and time
Ethnography (Anthropology in the Clinic)
the technical term used in anthropology for its core methodology; refers to an anthropologist’s description of what life is like in a “local” world, a specific setting in a society- usually one different from that of the anthropologist’s world
the ethnographer practices intensive and imaginative empathy for the experience of the natives- appreciating and humanly engaging with their forgiveness and understanding their religion, moral values, and everyday practices
the scientific description of the customs of individual peoples and cultures.
What is the explanatory models approach? (Anthropology in the Clinic)
it is used as an interviewed technique that allows a better understanding of how the social world affects and is affected by illness
Explanatory models ought to open clinicians to human communication and set their expert knowledge alongside the patient’s own explanation and viewpoint
by using this approach, clinicians are able to conduct a “mini-ethnography” which consists of 6 steps, also known as the Revised Cultural Formulation
Mini ethnography and the six steps of cultural formation (Anthropology in the Clinic)
Mini ethnography: the process of learning from people about aspects of their lives through defining questions, interviewing informants, observing, analyzing observations, and presenting findings over a short period of time
Cultural formation: Steps that clinicians may use to imply care, thought, and understanding of a patient through factors such as background, race, ethnicity, and social factors
6 steps of cultural formation:
Ethnic Identity
What is at stake?
The illness narrative- a series of questions aimed to acquiring an undertsanding of illness
Psychological stresses
Influence of culture on clinical relationships
The problems of a culture competency appraoch- must ask the question “does this actually work in practice?”, be aware of side effects
What are the differences between ethnography and cultural competency? (Anthropology in the Clinic)
Ethnography is different than cultural competency
It avoids the “trait list approach” that understands culture as a set of already-known factors
ex: Chinese eat pork, Jews don’t
Ethnography emphasizes engagement with others and practices that people undertake in their local worlds
There is an ambivalence that poeple feel or being between worlds with cultural competency does not
ex: Person who identifies as both African-American and Jewish
Hypertension (Hypertension among Black Women)
having a systolic blood pressure above 160 mm/Hg and/or having a diastolic blood pressure above 95 mm/Hg
the heart pumps blood from the left ventricle through the aortic valve, which separates the left ventricle and the aorta. the left ventricle must overcome the pressure in the aorta to be able to pass through the valve
A person with hypertension has increased blood pressure, which causes the left ventricle to need more force to overcome the pressure gradient
over a period of time, the muscles surrounding the heart will increase in size due to having to work harder, which unfortunately decreases the volume in the left ventricle, causing less blood to be circulated throughout the body
hypertension can be a treatable disease with the use of biomedical blood thinners if caught early, if untreated damage is irreversible.
Long term hypertension is a leading cause of heart failure, overtime patient experience; trouble breathing after muscle movement, dizziness, chest pains, etc
High pretention (Hypertension among Black Women)
an episodic, emotional condition where the blood suddenly rises and then falls, making the individual more likely to faint
thought to be caused by an individual’s particular emotional contexts
it cannot be treated or cured; the best that can be done is to avoid emotional trauma
High blood (Hypertension among Black Women)
a persistent condition of the blood that is too thick, rich, or heavy; the blood is thought to rise up to the head and stay there causing negative health consequences
thought to be caused by eating rich, heavy, and sweet foods
treated by drinking blood-thinning agents such as epsom salts or pickle juice
Variables that affect hypertension (Hypertension among Black Women)
Black women have high rates of hypertension compared to women of other racial or ethnic groups and are disproportionately affected by psychosocial stressors such as racial discrimination, gender discrimination, and caregiving stress. Evidence suggests that stress is associated with incident hypertension and hypertension risk.
Know the details of the study done on Black women in New Orleans (Hypertension among Black Women)
The report summarizes a study that investigated the relationship between beliefs about hypertension and compliance with antihypertensive treatment among black women receiving care at a public hospital clinic in New Orleans. The study included 54 black women aged 45-70 who were being treated for essential hypertension and another unrelated chronic disease. Each patient participated for 2 months.
Researchers conducted interviews with the patients to elicit their beliefs and attitudes about hypertension and general health. Home visits were made at 2-week intervals to monitor blood pressure and medication compliance. Compliance was categorized as "poor" (pill use <60%) or "good" (use >80%) based on medication diaries, field notes, and pill counts.
The study found that patients conceptualized their disease as "pressure trouble" or "pressure." Two groups of patients were identified: one group believed in the biomedical disease of hypertension, while the other group believed in the existence of two folk diseases, "high blood" and "high pertension," with distinct characteristics.
Patients with folk beliefs about "high blood" were more likely to be poor compliers with antihypertensive treatment compared to those who believed in biomedical hypertension. Patients who believed in "high pertension" had the highest likelihood of poor compliance. The study also noted that physicians were generally unaware of their patients' folk beliefs about hypertension.
the study found that folk beliefs about hypertension had a significant impact on compliance with antihypertensive treatment among black women, with those holding such beliefs being more likely to comply poorly. Additionally, there was limited awareness among physicians about their patients' folk beliefs related to hypertension.
epidemiology (Does Culture Affect Psychiatric Disorders)
the study of how and why illnesses arise in different populations
epidemiological data is used to design and assess disease prevention initiatives, as well as to guide disease care in people who have already developed disease
Symptomology (Does Culture Affect Psychiatric Disorders)
a set of symptoms exhibited by a patient that is characterized by a medical condition
particular symptom(s) patterns differ across patients in different cultures
various different case studies were conducted to see these differences in Western and non-Western societies among depressed and anxious patients
in more elitist societies (like North Korea and Russia), there is a baseline level of trauma that is looked at as normal (this forces serious disorders to be ignored)
Somatization (Does Culture Affect Psychiatric Disorders)
psychological concerns are converted into physical concerns
ex: stress can cause some people to develop headaches, chest pain, back pain, nausea, or fatigue
Acute psychosis (Does Culture Affect Psychiatric Disorders)
associated with a serious life event in a person without premorbid pathology and with recovery within days or weeks without any significant chronic symptoms or persistent disability—show that this disorder constitutes a much larger portion of acute psychoses in nonindustrialized, non-western societies than in the industrialized West
an acute mental health condition when there is a loss of contact with reality
confused thinking, delusions, and hallucinations
Schizophrenia (Does Culture Affect Psychiatric Disorders)
a serious mental disorder of unknown cause characterized by delusions, hallucinations, associations of unrelated ideas, social withdrawal, and lack of emotional responsiveness and motivation
Depression (Does Culture Affect Psychiatric Disorders)
a nonpsychotic disorder because its prevalence varies globally
The increase in depression rates in non-Western societies is attributed to the use of more culturally appropriate diagnostic criteria and standardized research methods. The pressures and problems associated with modernization in these regions have also contributed to higher rates of depression.
The report notes that in some societies, the expression of depression has become more common, even if the occurrence of the condition has not changed substantially. Factors such as uprooting, loss, and the stress of acculturation have led to elevated rates of depression in refugee, immigrant, and migrant populations.
Risk factors for depression have been identified, including relative powerlessness, absence of affective support, and social pressures, such as child rearing. Vulnerability to depression is influenced by these factors, along with cultural differences that may affect the sources of vulnerability.
Anxiety (Does Culture Affect Psychiatric Disorders)
a neurotic disorder because there is little valid cross-cultural epidemiological data (very cultural based, not globally)
Studies in non-Western countries, such as Iran and India, have reported similar or even higher rates of anxiety disorders. The report mentions the difficulty of diagnosing anxiety and somatoform disorders in rural areas with high rates of infectious diseases.
Research also suggests that women and individuals from lower socioeconomic classes have a higher risk of experiencing depression and anxiety disorders in various societies. Gender differences, as well as the impact of powerlessness and low self-esteem, play a role in the etiology of depression in women.
Where does schrizophrenia occur? (Does Culture Affect Psychiatric Disorders)
prevalence rates ranging from 2-10 cases per thousand population across a range of populations
Lower rates have been reported in less developed societies, with the highest rates in North America and certain European societies
and developing countries
the data for non-Western societies are very limited and controversial
The occurrence and course of schizophrenia are strongly conditioned by the political economy. Unemployment and economic depression in the West and the development of capitalist modes of wage labor in non-Western societies appear to lead to greater numbers of individuals manifesting schizophrenia and fewer of them improving
Does culture affect the occurrence of psychiatric disorders? (Does Culture Affect Psychiatric Disorders)
The passage suggests that the social and cultural context is a significant source of cross-cultural diversity in psychiatric disorders. It points out that while genetics, temperament, and other biographical variables may explain why only some individuals exposed to the same stressors become mentally ill, these factors have not been systematically studied outside the Western world.
The passage also mentions variations in the prevalence of anxiety and depression disorders in different cultures. It highlights the difficulty of obtaining valid cross-cultural data due to differences in diagnostic criteria and research methods. Furthermore, the influence of alcohol abuse on mental health is discussed, particularly in some American Indian and Alaskan Native populations.
How is acute psychosis different from long-term schizophrenia? (Does Culture Affect Psychiatric Disorders)
Acute Psychosis: Acute psychosis is a short-term, brief episode of severe mental disturbance. It typically lasts for a short period, often days to weeks, and is characterized by intense symptoms like hallucinations, delusions, disorganized thinking, and impaired insight.
Long-Term Schizophrenia: Schizophrenia is a chronic, long-lasting mental disorder. It persists over an extended period, typically lasting for at least six months, and often continues throughout a person's life. The symptoms of schizophrenia can be persistent and may include hallucinations, delusions, disorganized thoughts, social withdrawal, and negative symptoms.
How does depression in the US differ from depression in other countries? (Does Culture Affect Psychiatric Disorders)
The increase in depression rates in non-Western societies is attributed to the use of more culturally appropriate diagnostic criteria and standardized research methods. The pressures and problems associated with modernization in these regions have also contributed to higher rates of depression.
The report notes that in some societies, the expression of depression has become more common, even if the occurrence of the condition has not changed substantially. Factors such as uprooting, loss, and the stress of acculturation have led to elevated rates of depression in refugee, immigrant, and migrant
How does culture relate to the expression of psychosis? (Does Culture Affect Psychiatric Disorders)
Cultural Variation in Symptoms: Different cultures may influence the specific symptoms and forms of expression of psychotic disorders. Psychotic symptoms, such as hallucinations and delusions, may be influenced by culturally specific beliefs, symbols, and experiences. For example, cultural factors can affect the content of delusions or the nature of hallucinatory experiences.
Cultural Syndromes: Some cultures have their own culturally bound syndromes, which may resemble or be related to psychosis. These syndromes can involve behaviors or experiences that are considered abnormal in one culture but may have cultural significance in another.
Explanatory Models: Culture also shapes how individuals and their communities understand and explain psychosis. Cultural explanatory models influence the perceived causes, attributions, and explanations for psychotic experiences. These models can include supernatural, religious, or sociocultural explanations for psychosis.
Stigma and Social Responses: Cultural factors can influence the stigma associated with psychosis and the social responses to individuals experiencing psychotic symptoms. Stigmatizing beliefs about mental illness may be more pronounced in some cultures and affect help-seeking behaviors.
Cultural Competence: Mental health professionals need to be culturally competent and sensitive to the cultural context when assessing and treating individuals with psychosis. Effective care should consider cultural factors to provide more appropriate and acceptable interventions.
What is illness behavior? (Does Culture Affect Psychiatric Disorders)
how people react to their symptoms and seek help or, in the case of depression, attempt suicide
meaningful experience of symptoms and patterns of coping and help seeking—of appropriately matched samples of depressed or anxious patients in different societies
autism (What in the World is Autism?)
affects the brain’s normal development of social and communication skills
first notice between ages 1-3 through a development delay
lots of symptoms in language, development, social skills, behavior
early intervention leads to positive outcomes later in life for people with autism
people with autism will learn, problem-solve, and think from highly skilled to severely challenged
common ABA therapy (Applied Behavior Analyst): increase social abilities, completing tasks, learning new skills, communicating
Andrew Wakefield study (What in the World is Autism?)
published a research paper about a possible link between vaccines and the development of autism in children
The study included 12 children, which is considered a small and unrepresentative sample for drawing broad conclusions. The study reported observations of a purported new syndrome in children, including autism spectrum disorder, gastrointestinal issues, and the timing of vaccination.
The study faced criticism and sparked controversy within the scientific community. Subsequent investigations found conflicts of interest and ethical concerns
Despite the paper’s retraction and scientific consensus against the vaccine-autism link, the study’s publication had a lasting impact on vaccine hesitancy. it contributes to fears about vaccine safety and led to declining vaccination rates in some areas, resulting in outbreaks of preventable diseases
RADS (What in the World is Autism?)
some described as “lack of love”, a term that, for Koreans, conjures images of orphans craving affection and care (instead of autism, kids in Korea are often diagnosed with RAD)
in Korea, RAD is thought to be a condition mimicking autism caused by a mother’s absence of attachment to her son
by calling RAD simply “attachment disorder”, the blame can be more clearly placed on the mother
unlike autism, RAD, or lack or love, can be ameliorated by giving love; it is not a permanent condition
as autism diagnosis, however, it is seen as a statement that your child has no future
RAD is not a genetic condition, so it does not impugn (to challenge as false) the family and harm family members’ marriage prospects in the same way a genetic disease might
although RAD may stigmatize the mother, autism stigmatizes the whole family, past, present, and future
Vaccines and autism (What in the World is Autism?)
The book acknowledges that the association between vaccines, particularly the MMR vaccine, and autism has been a topic of concern, debate, and study. It describes how the vaccine-autism controversy gained widespread attention, especially after Andrew Wakefield's controversial study was published in 1998, suggesting a link between the MMR vaccine and autism.
Grinker discusses the impact of this controversy, which led to concerns about vaccine safety and a decline in vaccination rates in some areas. However, the book does not take a position on the validity of the vaccine-autism link. It highlights the importance of rigorous scientific research and critical thinking in understanding the causes and nature of autism.
It's important to note that scientific consensus strongly rejects any causal link between vaccines, including the MMR vaccine, and autism. Numerous large-scale studies and reviews have found no credible evidence to support such a connection. The vaccine-autism controversy is widely considered a myth, and vaccines are regarded as safe and vital for public health in preventing infectious diseases.
Autism in Africa case study (What in the World is Autism?)
The passage describes the story of a young Zulu couple, Suzanna and Golden Khumalo, and their 3-year-old son, Big Boy, who displayed signs of autism.
When Big Boy's parents noticed his unusual behaviors, such as not learning words, arm flapping, and avoiding eye contact, they wanted to seek the help of a medical doctor due to their belief in science. However, their parents insisted that Big Boy was possessed by a demon and needed to see a witch doctor (nyanga) instead.
The conflict between the generations escalated, and the Khumalos ultimately brought Big Boy to the witch doctor, fearing that traditional customs would prevail. To their surprise, the witch doctor diagnosed Big Boy with autism, claiming to have learned about it from the Internet.
Autism in India case study (What in the World is Autism?)
Shubra:
Shubrha is an Indian mother with a son named Gautam with autism. As a kid, he would often defecate in his pants and sometimes put his hands in his pants and play with his feces. At 15, he was interested in sex and was often very irritated and had violent outbursts, often scratching and hitting himself.
Shubrha asked a graduate student for advice about her son’s urges and the student suggested a course on sex education.
He was nonverbal so the student said he needed to be educated with photos and videos. These photos and videos were illegal so Shrubrha had to break the law. This was controversial but this was effective in helping and managing Gautam’s urges.
Amla:
Amla and her husband Anil were considered “Bohemians” because that means that didn’t fit among their community in Delhi as well as didn’t fit in the social norm
Anil had trouble providing for his family and ended up passing away, which her autistic son Sunil had immense trouble grasping
It’s a tradition within the Hindu culture that when a parent dies, the eldest son takes care of the cremation and lights a flame to the deceased’s lips to symbolize the spirit leaving the body. Sunil was unable to perform these as he was extremely distraught and confused at the sight of his dead father’s body and visitors crying all around him.
Amla was forced to go against Hindu tradition and break societal standards. Amla took her husband Anil to be cremated and even lit the fire herself.
As a result, Amla was outcasted by her late husband’s conservative family they vowed to never see nor speak to her again
Mamta:
Mamta had a son who did not behave like other children and had symptoms like poor eye contact, speech delay, and an inability to respond to his name
Mamta was determined to interact with her son so she left her mountain village to visit a child psychologist in New Delhi his son was diagnosed with autism and was given a treatment plan
Mamta’s mother-in-law refused to understand the child’s diagnosis and brought him to holy men and tantric, and was told the child was possessed by a demon
In their culture, it was a ritual to sacrifice a goat to ensure that boys were born healthy. A goat was not sacrificed in 13 years when the child was born. Mamta’s mother-in-law blamed themselves and blamed Mamta for learning about autism rather than listening to the priests
Autism v.s. RADS (What in the World is Autism?)
unlike autism, RAD, or lack or love, can be ameliorated by giving love; it is not a permanent condition
as autism diagnosis, however, it is seen as a statement that your child has no future
RAD is not a genetic condition, so it does not impugn (to challenge as false) the family and harm family members’ marriage prospects in the same way a genetic disease might
although RAD may stigmatize the mother, autism stigmatizes the whole family, past, present, and future
PTSD (Veterans living with PTSD)
a mental health condition that is characterized by a range of symptoms following exposure to a traumatic event or events
The text discusses the high prevalence of PTSD among veterans, particularly those who have been deployed to combat zones. It highlights that a significant number of veterans returning from war zones experience symptoms of PTSD.
The text elaborates on the various symptoms and impacts of PTSD, including hyperarousal, flashbacks, nightmares, intrusive thoughts, and emotional numbness. It explains how these symptoms can severely disrupt a veteran's daily life and functioning.
The text emphasizes the stigma associated with mental health issues in the military culture. Many veterans may hesitate to seek help for fear of being labeled as weak or unreliable.
The text also discusses the barriers that veterans face in accessing mental health treatment for PTSD. These barriers include long wait times, limited availability of specialized care, and geographical constraints.
Some veterans resort to self-medication through alcohol or drugs as a coping mechanism, which can exacerbate their problems.
The text acknowledges that PTSD is a complex condition and that each veteran's experience with it is unique. It is not a one-size-fits-all diagnosis
Despite the challenges, the text also highlights the resilience of many veterans living with PTSD. It describes how some veterans, with the right support and treatment, can learn to manage their symptoms and lead fulfilling lives.
Shell shock (Veterans living with PTSD)
describes the psychological and emotional trauma experienced by soldiers exposed to the intense shelling and combat conditions of the trenches
symptoms include anxiety, fatigue, disorientation, nightmares, and even physical symptoms like tremors and tics
initially misunderstood as a sign of weakness or cowardice, but it was later recognized as a legitimate psychological response to the extreme stress of combat. The condition laid the groundwork for our modern understanding of post-traumatic stress disorder (PTSD)
Machismo (Veterans living with PTSD)
a complex of masculine behavior and attitudes widely held in the be common across Latin America
the literature on machismo often casts it in fairly negative terms, emphasizing hyper-masculine traits, such as physical and emotional toughness, sexual jealousy, a stiff-necked and unbending aggressiveness, and the exercise of control over women
Experiences of Latino veterans with PTSD (Veterans living with PTSD)
In this research, the author explores how male veterans understand their masculinity and whether it influences their experiences of and responses to PTSD. The study was conducted in San Antonio, where 50% of the veterans identified themselves as Hispanic or Latino.
One common assumption is that Latinos may be more prone to PTSD due to cultural factors like coping through self-blame, perceived racism, or dissociation at the time of trauma. Another assumption is that Latino men are influenced by the concept of "machismo," which is often associated with hypermasculine traits. However, the author's findings challenge these stereotypes.
He observed a wide range of responses within both Latino and non-Latino groups, indicating that individual differences within these groups are often more significant than the differences between them.
The central point is that cultural influences can affect how veterans and their families respond to PTSD, including seeking treatment or social support. However, the relationship between ethnicity and PTSD is not straightforward, and individual experiences and cultural influences can vary widely. The study emphasizes the importance of considering individual differences and the rich cultural mix that characterizes diverse communities like San Antonio and the United States as a whole.
Methods to treat PTSD (Veterans living with PTSD)
psychotherapy & medication
Stigmas with PTSD relating and not relating to military service (Veterans living with PTSD)
It delves into how the stigma surrounding mental health issues, including PTSD, can affect veterans and their willingness to seek help. The text also explores how military culture and the perception of mental health care can contribute to these stigmas.
Additionally, it highlights how veterans with PTSD may experience stigmatization not only in the context of their military service but also in their civilian lives (employment discrimination, social isolation, lack of understanding)
Leprosy/Hansen’s Disease (Learning to be a Leper)
a chronic and communicable disease caused by Mycobacterium Leprae
the disease affects the eyes, skin, internal organs, peripheral nerves, and mucous membranes
considered mildly communicable, mode of transmission is not entirely understood (long-term or respiratory contact of about 10-15 years)
The most common treatment is sulfone drugs administered over a long period of time. Sulfone drugs are known to inhibit the growth of bacteria, causing a drop in the number of bacteria present, making most patients no longer communicable. Surgery is also used in severe cases
Symptoms → anesthetic skin, raised patches resembling eczema, non-healing skin ulcers
stigma (Learning to be a Leper)
a set of negative and often unfair beliefs that a society or group of people have about something
Individuals diagnosed with leprosy face social rejection, isolation, and are labeled as "lepers." Stigmatization leads to physical and social marginalization, with affected individuals often removed from their communities.
The study highlights the profound impact of societal stigmatization on those with leprosy and how they may engage in stigma management to cope with the challenges they face. It underscores how illnesses can be socially constructed, resulting in discrimination and isolation.
What is the cause of leprosy? (Learning to be a Leper)
the bacterium Mycobacterium leprae
How different countries/cultures view lepers (Learning to be a Leper)
India- Structural Exclusion of Lepers
- Completely removed from families
- No familial inheritance, Can’t get insurance, Leper trains
- Huge social stigma surrounding leprosy– forced to become beggars
- Proposed sterilization of male lepers
Sri Lanka
- No structural stigma– Social stigma fades over time
- Lepers tend to stigmatize themselves
Nigeria– Just like any other disease
- Lepers live very normal lives
- No social stigma
- Ethnomedicine is used to treat them– burning and scraping of wounds, potions
Social Structures and Cultural Norms Matter
- Hinduism in India (Caste System)
- Buddhism in Sri Lanka
Does leprosy have more social or biological impacts on the individual? What are they? (Learning to be a Leper)
Social Impacts:
a. Stigmatization: Leprosy has been historically associated with stigma and discrimination. People affected by leprosy often face isolation, exclusion, and negative social attitudes. Stigmatization can lead to social withdrawal, loss of employment, and strained family relationships.
b. Isolation: In some cultures and historical periods, individuals with leprosy were segregated from the rest of the population. They were forced to live in leper colonies or isolated communities, contributing to their social isolation.
c. Psychological Effects: The social stigma attached to leprosy can lead to psychological distress, including depression, anxiety, and feelings of shame and low self-esteem.
d. Economic Impact: Leprosy can affect an individual's ability to work and earn a living. As a result, economic hardships may occur, leading to poverty and decreased access to healthcare and education.
e. Discrimination: Discrimination against people with leprosy can extend beyond isolation to issues such as access to housing, education, and healthcare. In some cases, they may also experience discrimination in marriage and other social interactions.
Biological Impacts:
a. Nerve Damage: Leprosy primarily affects the peripheral nerves. The bacteria responsible for leprosy can damage nerves, leading to sensory and motor impairment. This can result in a loss of sensation, muscle weakness, and deformities in the hands and feet.
b. Skin Lesions: Leprosy often presents as skin lesions and nodules. These skin manifestations can be disfiguring and are typically the first visible signs of the disease.
c. Ocular Involvement: Leprosy can affect the eyes, leading to eye damage and potential blindness.
d. Secondary Infections: Loss of sensation in affected areas can lead to secondary injuries and infections, as individuals may not feel pain or notice wounds or sores.
e. Disfigurement: In advanced cases, leprosy can cause deformities, such as clawed hands and foot drop, which can have long-term physical and functional consequences.
Cancer (Strategic suffering)
People experience living with chronic conditions such as cancer as both “disease”—the physical disruption of bodily processes—and as “illness”—the subjective experience of the disruption as it interrupts their life. At times the experience of disruption may be extensive, presenting permanent challenges to the identity of the afflicted individual, not allowing them to continue living in the familiar world
Mexico, as so in the world, cancer has a powerful
metaphoric dimension, it conjures images of an
insidious invasion of victims by aggression
Cancer disrupts one's identity but may also disrupt
their social life as well
Sex and gender politics (Strategic suffering)
In "Strategic Suffering in the Illness Narratives of Mexican Cancer Patients" by Linda Hunt, the text explores the ways in which sex and gender politics play a significant role in the illness narratives of Mexican cancer patients. Here are some key points related to sex and gender politics in the text:
Gendered Experiences: The text highlights that the experience of cancer is profoundly gendered, and the illness narratives of male and female patients differ. Men and women may experience cancer differently, and their narratives reflect the ways in which social expectations around gender influence their experiences.
Women's Narratives: The text emphasizes that women often adopt the role of stoic sufferers in their narratives. They may downplay their pain and suffering, seeking to protect their families and fulfill traditional gender roles as caregivers. This can lead to the strategic use of suffering to maintain gendered expectations.
Men's Narratives: Male cancer patients, on the other hand, may grapple with their own expectations of masculinity. The text discusses how some men may feel emasculated by the physical and emotional challenges of cancer and how this affects their illness narratives.
Gendered Expectations: The text delves into the societal expectations placed on both men and women in Mexico, such as women being expected to endure suffering for the sake of their families and men being expected to be strong and unyielding.
Negotiating Gender Roles: Patients often navigate these gendered expectations in their narratives. Women may strategically frame their suffering in ways that align with societal norms, while men may grapple with their vulnerability and express their emotions differently.
Linda Hunt (Strategic suffering)
Linda Hunt teaches medical anthropology at Michigan State University. She is a faculty member in the Center for Ethics and Humanities in the Life Sciences, which is part of the medical school. She studied at Harvard University, with Arthur Kleinman, and has done research both in the United States and Mexico. Much of her work concerns Latino patients’ experiences with the health care system; she pays particular attention to issues of chronic disease management for such conditions as cancer and diabetes.
What is strategic suffering? (Strategic suffering)
a conscious and purposeful use of suffering as a means of achieving specific goals or outcomes
It involves the strategic presentation of pain, distress, or hardship by individuals facing cancer in order to achieve particular objectives within their cultural, social, or personal contexts.
Hunt's study explores how Mexican cancer patients strategically employ narratives of suffering to navigate their healthcare experiences, secure support from their social networks, and access necessary resources. Strategic suffering may involve emphasizing certain aspects of their illness experiences or narratives to gain sympathy, support, or desired treatment options. It can also encompass cultural, gender, or social dynamics that influence how patients present their suffering to achieve specific goals.
Strategic suffering is not solely about experiencing pain but also about strategically communicating and framing their suffering to address their unique needs and challenges within their cultural and social contexts.
How did disease empower Isabella and Roberto in the presentation on Strategic Suffering? (Strategic suffering)
What is disruption in this context? (Strategic suffering)
Building Social Networks: Both Isabella and Roberto found that their experiences with disease enabled them to build strong social networks. They were able to garner support from family, friends, and community members who empathized with their suffering. This social support was crucial in helping them cope with their illnesses and navigate the healthcare system.
Gaining a Sense of Agency: Disease empowered Isabella and Roberto by giving them a sense of agency over their healthcare decisions. They became actively involved in seeking medical care, making treatment choices, and advocating for their needs. This active role in managing their illnesses allowed them to regain a sense of control over their lives.
Coping Mechanism: For both Isabella and Roberto, disease became a coping mechanism. By sharing their illness narratives and strategically emphasizing their suffering, they were able to access resources, including financial assistance and medical services, which they might not have obtained otherwise.
Reshaping Identities: Disease also played a role in reshaping their identities. Isabella and Roberto's experiences with illness prompted them to reflect on their roles within their families and communities. They became sources of inspiration and support for others facing similar challenges.
Advocacy and Empowerment: Both individuals used their illness experiences as a platform for advocacy. Isabella, for example, became a vocal advocate for cervical cancer screening and prevention. Their personal experiences with disease transformed them into advocates for raising awareness about their conditions and influencing healthcare policies.
What makes up the timeline of strategic suffering? (Strategic suffering)
Diagnosis and Shock: Initial diagnosis and emotional response.
Narrative Construction: Crafting stories to make sense of the illness.
Treatment Journey: Seeking and undergoing medical treatment.
Social and Family Networks: Sharing narratives to seek support.
Healthcare System Interaction: Navigating healthcare with narrative influence.
Cultural and Gender Dynamics: Dealing with societal norms.
Coping and Resilience: Developing coping strategies.
Narrative Adaptation: Adjusting narratives over time.
Advocacy and Support: Engaging in advocacy and support efforts.
Reflection and Transformation: Reflecting on the experience and personal growth.
What are the secondary gains of chronic illness? (Strategic suffering)
Enhanced Social Connections: The illness provides opportunities for individuals to strengthen relationships with family and friends as they offer support and care.
Identity and Role Shift: Patients may experience a reevaluation of their identity and roles within the family and society, allowing them to take on new responsibilities or challenge traditional roles.
Narrative Expression and Coping: Chronic illness allows individuals to express their suffering and cope with their experiences through storytelling, which can be empowering.
Advocacy and Empowerment: Some patients become advocates for themselves and others, raising awareness about their condition and engaging in efforts to improve healthcare services.
Self-esteem (The Damaged Self)
confidence in one's own worth or abilities; self-respect
having a disability can lead to lower self esteem, the feeling of aloneness, and the desire to shrink from society into oneself
Robert Murphy (The Damaged Self)
Robert Murphy taught anthropology at Columbia University, and his original fieldwork, that was conducted with his spouse Yolanda, dealt with social structure of the Mundurucu, who live in the Amazon Rainforest of Brazil. Murphy made significant contributions to cultural-ecological, social structural, and symbolic approaches to the field
In 1974, Murphy began to lose control of his lower extremities and was diagnosed with a slow-growing spinal tumor; two years later, he was a wheelchair user. Funded by the National Science Foundation, he began research on the anthropology of disability and produced an important, reflective, and experience-near ethnography of physical disability.
Myth of Asexuality (The Damaged Self)
It highlights the misconception that people with mental health conditions are often seen as lacking sexual desires or interests. The text points out that this myth is inaccurate and stigmatizing, as individuals with psychiatric disorders, like anyone else, have their own sexual desires and needs.
It emphasizes the importance of recognizing the diverse experiences and needs of individuals with mental health conditions, including their sexual and emotional lives, to provide more holistic and effective support and care.
embodiment and disembodiment (The Damaged Self)
Embodiment: the experience of one's body and emotions as integral to one's self. It involves a sense of being connected to one's body and emotions and feeling a continuity of self.
In these cases, their sense of self remains intact, and they perceive their bodies and emotions as integral to who they are.
For example, a person with a psychiatric disorder might have intense emotional experiences and a keen awareness of their bodily sensations, and these experiences contribute to their overall sense of self.
Disembodiment: the disruption of this connection. It involves a sense of detachment from one's body and emotions, leading to a fragmented or disintegrated self. Individuals with psychiatric disorders may experience disembodiment as a result of their condition, which can affect their sense of self and agency.
This means that they feel detached from their own bodies and emotions. They may describe feeling as if their bodies and emotions belong to someone else or exist separately from their core identity. Disembodiment can result in a fragmented or disintegrated sense of self.
For instance, a person with a severe psychiatric disorder might feel that their body and emotions are beyond their control and are alien to their true self.
According to Murphy, what is the most destructive psychological symptom of being physically disabled? (The Damaged Self)
a person's sense of self can be profoundly affected by physical disability, leading to feelings of loss, diminished self-esteem, and a sense of being "damaged." These emotional and psychological challenges can manifest differently in each individual but generally revolve around themes of self-worth, self-identity, and adaptation to the new physical and social realities imposed by the disability.
Understand how disability interacts with sex and sexual identity (The Damaged Self)
Body Image and Self-Esteem: Physical disability can lead to changes in body image and self-esteem. Individuals with disabilities may experience negative body image due to physical differences, which can affect their self-esteem and self-worth, including how they perceive themselves in a sexual context.
Sexual Identity: The text touches on how physical disability can influence an individual's sexual identity. It recognizes that individuals with disabilities have diverse sexual orientations and gender identities, and they may face unique challenges related to their sexual identity, which can be influenced by societal perceptions and expectations.
Barriers to Intimacy: Physical disabilities can pose practical challenges to sexual intimacy, including mobility limitations and the need for adaptive strategies. These challenges can affect an individual's ability to engage in sexual activities and may require adjustments and accommodations.
Social Stigma and Stereotypes: The text discusses how individuals with disabilities may encounter stereotypes and social stigmas related to their sexual capabilities. These stereotypes can affect their relationships, self-confidence, and emotional well-being.
Support and Education: The text emphasizes the importance of providing support and education for individuals with disabilities in the realm of sex and sexuality. Access to information, healthcare services, and emotional support can help individuals navigate the complexities of sexual identity and intimacy.
What are some of the elements of emasculation? (The Damaged Self)
Physical Impairment: Physical disability often involves the loss of bodily functions or the ability to perform physically demanding tasks. This loss can lead to feelings of emasculation, as traditional masculinity is often associated with physical strength and capability.
Dependence: Many men with physical disabilities become dependent on others for assistance with daily activities. This reliance on caregivers or family members can be perceived as emasculating, as traditional masculinity values self-sufficiency and independence.
Loss of Sexual Function: Disabilities can affect sexual function, leading to challenges in achieving or maintaining an erection, for example. This can threaten traditional notions of male sexual prowess and virility.
Social Stigma: Societal attitudes and stereotypes about disability can contribute to emasculation. Negative stereotypes may suggest that disabled men are less masculine or sexually unattractive.
Role Changes: Disability may force men into roles typically associated with women, such as caregiving or homemaking. These role changes can challenge traditional gender expectations and a man's sense of masculinity.
Psychological Impact: Coping with the physical, emotional, and social challenges of disability can lead to depression and anxiety. These mental health issues can further erode self-esteem and perceptions of masculinity.
Loss of Autonomy: The loss of autonomy and the need for assistance in decision-making can make men with disabilities feel emasculated, as traditional masculinity values autonomy and self-control.
Barriers to Social Participation: Physical or social barriers that limit participation in traditionally masculine activities, such as sports or certain careers, can reinforce feelings of emasculation.
Body Image and Self-Esteem: Negative body image resulting from physical changes due to disability can undermine self-esteem and contribute to emasculation.
How does someone’s identity become his or her disability? (The Damaged Self)
Social Perception and Labeling: When society interacts with a person with a disability, they are often labeled and defined by their disability. This labeling can lead the individual to incorporate this identity into their self-concept.
Stigmatization: Stigmatization occurs when people with disabilities are negatively stereotyped, pitied, or treated as helpless. These societal attitudes can influence how individuals perceive themselves and their roles.
Social Role and Expectations: The roles and expectations assigned to individuals with disabilities can shape their self-identity. For example, if they are seen primarily as patients or recipients of care, they may come to view themselves through this lens.
Experiential Factors: Personal experiences related to disability, such as medical interventions, therapies, or repeated interactions with healthcare professionals, can reinforce the identity of being a "disabled person."
Psychological Impact: The psychological and emotional challenges that come with disability, such as depression, anxiety, or feelings of inadequacy, can lead to the incorporation of the disability identity.
Adaptive Strategies: Some individuals may adopt a disability identity as an adaptive strategy to cope with their condition or to gain access to support services.
Social Comparison: Comparing oneself to others who share the same disability identity can further reinforce that identity. Socializing within disability communities can provide a sense of belonging and shared experience.
Advocacy and Empowerment: On the positive side, some individuals may embrace their disability identity as a form of empowerment and advocacy. They may take pride in challenging societal norms and promoting disability rights and inclusion.
Know what Murphy means when he talks about being “disembodied” (The Damaged Self)
Murphy uses this term to describe a profound disconnect or disassociation that can occur between a person and their own body.
Individuals with physical disabilities often experience a sense of disconnection from their bodies due to the loss of physical wholeness. They may perceive their bodies as incomplete, damaged, or as sources of pain and limitation.
Engel’s law (When Food Prices Sky Rocket)
household incomes rise, the percentage of income spent on food decreases and more money goes to other goods or services
Food insecurity (When Food Prices Sky Rocket)
a lack of food to adequately meet these needs
Coffee ceremony (When Food Prices Sky Rocket)
The Ethiopian coffee ceremony is a highly ritualized activity that involves roasting, grinding, and brewing coffee and consuming it together with small snacks such as popcorn, injera, bread, or qollo (roasted grains).
“The price of coffee is killing us.”
During the coffee ceremony, neighbors and friends come together to share stories and news, almost always in someone’s home. As one respondent put it, “Coffee ceremonies allow you to meet with people daily”; or another: “In Ethiopia, coffee brings people together.”
In the wake of the rise of food prices, the coffee ceremony, or aspects of it, were apparently eroded, at least among the urban poor, with a decline in the frequency of ceremonies and in the numbers of people participating in any given ceremony.
Know the background of the Ethiopian food crises (When Food Prices Sky Rocket)
Global Food Crisis: The food crisis in Ethiopia was part of a larger global food crisis that occurred in the late 2000s. During this period, there were significant increases in the prices of staple foods worldwide. This global phenomenon was influenced by factors such as rising oil prices, increased demand for biofuels, changing weather patterns, and financial speculation in commodity markets.
Ethiopia's Vulnerability: Ethiopia, like many other developing countries, was particularly vulnerable to the impacts of the global food crisis. The country had a history of food insecurity and periodic famines, and a significant portion of its population lived in poverty and relied on subsistence farming.
Agricultural Challenges: Ethiopia's agricultural sector faced various challenges, including issues related to land productivity, access to resources, and vulnerability to climate-related shocks like droughts. These challenges contributed to the country's reliance on food imports, making it susceptible to rising global food prices.
Effects of High Food Prices: The high food prices had severe consequences for Ethiopian households. Families struggled to afford basic food items, leading to increased food insecurity and malnutrition. Children and pregnant women were particularly at risk of suffering from malnutrition-related health issues.
Government and International Responses: In response to the food crisis, the Ethiopian government and international organizations implemented various policies and programs to address the immediate food security needs of the population. These responses aimed to stabilize food prices, provide food assistance, and support vulnerable households.
Long-Term Challenges: While addressing the immediate impacts of the food crisis was essential, the background also includes a focus on addressing the underlying issues of food security in Ethiopia. This involves strategies for improving agricultural productivity, ensuring access to resources for farmers, and building resilience to climate-related challenges.
Know how Ethiopians deal with the food insecurity crisis (When Food Prices Sky Rocket)
Government help: The government gives cash or food to needy families.
Community support: Neighbors and family share food and resources.
Growing different crops: Farmers grow various crops to reduce the risk of crop failure.
Raising animals: Many people own animals like cows and goats, which can provide food and money.
Moving to cities: Some people from rural areas move to cities to find work and make money.
Food aid: International groups provide food aid during crises.
Protecting the environment: Farmers use eco-friendly techniques to improve soil and withstand droughts.
Building resilience: Programs help communities prepare for climate changes and disasters.
Preserving food: People use traditional methods like drying and fermenting to make food last longer.
Early warnings: Systems predict food shortages, so people can prepare.
Farming help: Organizations offer training to improve farming and income.
Know the physical, social, and psychological consequences of starvation and malnutrition (When Food Prices Sky Rocket)
Physical Consequences: Starvation and malnutrition lead to physical health problems. These include stunted growth in children, weakened immune systems, and a higher susceptibility to diseases. Chronic hunger can cause physical and developmental issues, particularly in young children.
Social Consequences: Food scarcity can result in social challenges. Families may have to make difficult choices about which family members get to eat, potentially leading to unequal access to food. This can strain family relationships. Food scarcity can also contribute to migration as people seek better opportunities in urban areas.
Psychological Consequences: Hunger and food insecurity can lead to psychological distress. People may experience stress, anxiety, and depression due to not having enough to eat. This can affect their overall mental well-being and may hinder their ability to work and provide for their families.
Anorexia (Demedicalizing Anorexia)
In biomedicine, anorexia is classified as
eating disorder and a serious mental health
condition
Characterized by very low body weight,
intense fear of gaining weight, and having
a distorted perception of weight
High value is placed on controlling
weight/shape
Not really about food, it is an unhealthy
and life-threatening way to cope with
emotional problems/trauma
Cartesian dualism (Demedicalizing Anorexia)
traditionally separates mind and body, has influenced the understanding and treatment of anorexia
It suggests that this dualistic perspective has been problematic in addressing anorexia as a purely medical or psychological issue.
Instead, the authors argue for a more holistic and culturally informed approach to anorexia, recognizing that cultural, social, and psychological factors are interconnected and play a significant role in the experience and treatment of this condition
Asceticism (Demedicalizing Anorexia)
involves self-discipline and self-denial often for spiritual or moral purposes, has been associated with anorexia
it suggests that the connections between ascetic practices and anorexia can be complex, and not all individuals with anorexia are motivated by asceticism.
However, it acknowledges that in some cases, anorexic behaviors may be interpreted as a form of asceticism, as individuals may engage in extreme dietary restrictions and self-control as a way to gain a sense of mastery or to meet cultural ideals of self-discipline.
severe self-discipline and avoidance of all forms of indulgence, typically for religious reasons.
Empiricism (Demedicalizing Anorexia)
the idea that all learning comes from only experience and observations
The information is based on the accounts of various individuals who spoke independently about their experiences. These narratives reveal a consistent pattern in the development of anorexia, which appears quite ordinary until the final step of becoming anorexic, a step described as mysterious.
However, the authors suggest that empirical evidence does shed some light on the transition into anorexia. They identified eight recurring features that, when considered together, indicate how intense food restriction and exercise integrate into a self-sustaining system. The article argues that empiricism can provide answers that medicalization tends to dismiss, and it advocates for addressing the obvious aspects of anorexia, rather than speculating about obscure underlying pathologies. This approach is seen as both better science and better medicine, as it allows anorexics to participate in their own recovery, in contrast to programs where specialists take control.
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