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152 Cards in this Set
- Front
- Back
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What is Anthropology?
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The Study of Human Beings
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4 Fields of American Anthropology
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Archaeology, Cultural, Linguistics, Physical
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What is Culture? [4]
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- beliefs and practices of a particular group
- values, behaviors, and material objects that form a people's way of life - unconscious in that we don't think about it, we live it Lens through which we see the world |
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“Culture is that complex whole which includes knowledge, belief, art, morals, law, custom and any other capabilities and habits acquired by man as a member of society”
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Tylor, 1871
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Components of Culture. Though all cultures vary they all have... (5)
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Symbols, Language, Beliefs, Values, Norms
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Defines culture as a “historically transmitted pattern of meanings embodied in symbols, a system of inherited conceptions expressed in symbolic forms by means of which men communicate, perpetuate and develop their knowledge about and attitudes towards life.”
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Clifford Geertz
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“Globalization involves expanding worldwide flows of material objects and symbols, and the proliferation of organizations and institutions of global reach that structure these flows…It encompasses webs of significance that span the globe, conceptions of world society and world order, and models of organizing social life that are assumed to have worldwide significance or applicability.”
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Culture and Globalization
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“Believing with Max Weber, that man is an animal suspended in webs of significance he himself has spun, I take culture to be those webs, and the analysis of it to be therefore not an experimental science in search of law but an interpretive one in search of meaning.”
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Webs of Significance
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The Sapir- Whorf Thesis
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People perceive the world through the cultural lens of language-- language determines what categories you have available to describe and experience the world
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Values
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Shared ideas about what is desirable and "good"
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Beliefs
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Statements or principles that a person or a group holds to be true
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Some key values of US culture
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Individuality, Equal Opportunity, Achievement and success, Material comfort, activity and work, practicality and efficiency, progress, science, democracy and free enterprise, freedom.
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Ethnocentrism
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The practice of judging another culture by one's own culture
- can be difficult to escape viewing the world through the lens of one's own culture |
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Cultural Relativism
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The practice of evaluating a culture by its own standards
- requires understanding of unfamiliar values and norms |
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Medical Anthropology
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Studies all cultural and social aspects of health, disease and illness
- concerned with both micro and macro aspects of health |
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defines health as “not merely the absence of disease and infirmity, but complete physical, mental and social well being.”
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World Health Organization (WHO)
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Does Social Context matter to health outcomes?
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YES. Lower Socio- economic status associated with lower life expectancy, higher overall mortality, higher infant and prenatal mortality, as well as each of the 14 major cause of death categories, and more mental illness
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“All medicine is social science.”
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Virchow
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3 Approaches in Medical anthropology
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Ecological- concerned with adaptations to particular environments that support human survival
Interpretive- meaning an individual gives an illness experience Critical- considers larger political and economic context of health and illness. |
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Interpretive approach
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- Developed in response to ecological approach that was lacking interest in the deeper meaning and significance of illness
basic point- where you seek illness depends on your interpretation of the illness |
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“It understands health issues within the context of encompassing political and economic forces – including forces of institutional, national and global scale – that pattern human relationships, shape social behaviors, condition collective experiences, reorder local ecologies and situate cultural meanings.”
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Farmer's idea of "structural violence"
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looks for a “corrective for the disciplinary fragmentation of social science that obscures the relationship of economic, political, social and cultural forces…. It attempts to integrate analyses of global processes with ethnographic detail”
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CMA
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CMA criticizes colleagues for..
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Criticizes conventional colleagues for adopting an ahistorical, apolitical, and cultural relativistic stance
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“The culture of a society constructs the way societal members think and feel about sickness and healing. That is to say, the members of a society are by others about different sicknesses and their names, their characteristic symptoms and courses, their causes and mitigating circumstances, their cosmological and moral significance, and appropriate responses. What counts as sickness may differ from society to society, and given conditions of sickness are understood in very different ways. Anthropologists refer to part of a society’s cultural reality concerned with sickness and healing as its “ethnomedicine.
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Nichter, 1991
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“…the study of the medical systems or healing practices of a cultural group, the cross-cultural comparison of such systems, and increasingly the study of different medical therapies”
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Erickson on Ethnomedicine
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Biomedicine is now considered only one of many medical systems that can be studied
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Erickson, p4
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Terms for nonbiomedical healing systems such as indigenous, alternative, unorthodox, folk, ethnic, fringe, traditional and unofficial “highlighted their difference form biomedicine and often implied their inferiority”
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Erickson
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“It is undeniable that alternative therapies have become accepted by consumers of medical care in the West. In 1997, 42 percent of Americans used some form of alternative medicine”
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Erickson
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Ethnomedicine
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- "alternative, folk, traditional" medicine
- often seen as inferior - New terms include Complementary and Alternative medicine (CAM) or "Integrative" medicine |
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“Priority is given to the individual and his/her illness rather than the social context of ill health (e.g., family, environment, racism, poverty, etc.) and the role it plays in causation or exacerbation of illness. In these ways, our medical system reflects our core cultural values of independence, individualism, scientific positivism, and capitalism.”
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Erickson on American Medicine, p.5
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“In Western culture and its medical system, personal responsibility for health is a paramount theme and those who “choose” lifestyles that lead to illness are held responsible for those illnesses.”
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Erickson
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3 sectors of healthcare
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- popular
- professional - folk medicine |
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popular sector
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nonprofessional- where illness is first recognized and where an estimated of 70-90% of healthcare takes place, reflecting culture
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professional sector
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includes both biomedicine and alternative healthcare
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folk medicine
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diverse types of sacred and secular healers, operating between popular and professional sector
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Medicalization
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The process by which previously non-medical experiences and more of everyday life has come under the supervision of medicine
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“Medicine, like law and religion, defines what is normal, proper and desirable. Medicine has the authority to label one man’s complaint a legitimate illness, to declare a second man sick though he himself does not complain and to refuse a third social recognition of his pain, his disability and even his death…. He is a moral entrepreneur charged with inquisitorial powers to discover certain wrongs to be righted.”
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Ivan Illich from Medical Nemesis
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Negatives to medicalization
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- making social problems individual problems
- depoliticizing behavior - tyranny of the experts - dislocating responsibilities - "no-fault" diseases - no place for discussion of values and ethics |
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Reification
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To treat something abstract as if it existed as a real and tangible object
- Does defining something in itself justify treatment? |
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Examples of medicalization
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- baldness, anorexia, childbirth, alcoholism, obesity, compulsive gambling, shyness
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Why has medicalization increased? [4]
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- more limited power of religion in modern life
- idea of cultivating "health" at the center of moral life - faith in progress, science, and rationality - some people exmbrace medicalization |
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Baron Cohen's article
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- Central question is whether aspergers/HFA is a disability or an "alternative cognitive style"
- How tolerant are we of differences in this culture? |
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Taylor- Story Catches You
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- Spirit Catches You and You Fall Down as a "canonical" text for cultural competence
- book has simplistic view of culture In anthropology today culture is dynamic, it is seen as competing discourses and practices in the context of unequal distribution of power |
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“…basically what you're supposed to do is take a walking, talking, confusing, disorganized (as we all are) human being, with an array of symptoms that are experienced, not diagnosed, and take it all in, put it in the Cuisinart and puree it into this sort of form that everyone can quickly extrapolate from. They don't want to hear the story of the person. They want to hear the edited version. You're not there to just talk with people and learn about their lives and nurture them. You're not there for that. You're a professional and you're trained in interpreting phenomenological descriptions of behavior into physiologic and pathophysiologic processes. So there's the sense of if you try to tell people really the story of someone, they'd be angry; they'd be annoyed at you because you're missing the point. That's indulgence, sort of.”
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The Psychosocial
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Practical suggestions from taylor to healthcare workers
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- replacing cultural competence with cultural humility
- "Culture" has to be put in context of SES, living conditions, and literacy - Understanding the basic concept of "other" or "othering" is more important than "cultural competency" or knowledge of specific cultural practices |
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Taylor's suggestions
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- would like doctors to acknowledge their view as just a view and not reality
- recognize the narrative of medicine as: 1) heroic battle against disease, 2) Heroic battle against the dehumanizing aspect of modern medicine |
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Drug
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Any substance ingested to modify one or more functionsof a living organism
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Psychoactive
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affects mental state
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Addiction
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Compulsive use of habit forming drugs (or activities? food?) possibly in absence of physical dependence
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Disease
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Pathological condition of the body that presents with specific signs, symptoms, and lab findings
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Addiction (extended)
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- Genetic component suspected
- some students have found variants of genes that greatly increase likelihood of addiction - dopamine receptors in the brain are implicated these persons might become addicted more easily than others |
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Addiction (secondary def.)
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- continued making of maladaptive choices, even in the face of explicitly stated desire to make a different choice
Mark Twain- Addiction is other people's bad habits |
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more influences in medicine rather than pharmacology..
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- its color, shape, name, taste
- person's culture, education, emotional state - doctor's professional status, age, attitude, white coat - Physical setting of a doctor's office, lab, party, other people's reactions |
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Sacramental Use of Drugs
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Used in Ancient history/ religious context
substances include peyote (Native Americans), Yage (south America), Marijuana/Hash (N. Africa, middle east, Caribbean) |
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Kramer- Listening to Prozac
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- Influential book
- medication affects personality “the medicalization of personality” - discusses 'art' of prescribing |
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“We have found a medication that can affect personality, perhaps even in the absence of illness.”
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Kramer- Listening to Prozac
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They “felt more like themselves, than they had their entire lives.”
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Kramer- Listening to Prozac
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Use of Antidepressants
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2005- CDC reports antidepressants most frequently prescribed drug class
- 2.4. billion prescriptions written in 2005, 118 million for antidepressants - continuing controversy over these prescriptions |
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“Meanwhile pharmacology, biochemistry and neurology are on the march, and we can be quite certain that in the course of the next few years, new and better chemical methods for increasing suggestability and lowering psychological resistance will be discovered. Like everything else, these discoveries may be used well or badly. More probably, since science is divinely impartial they will both enslave and make free, heal and at the same time destroy.”
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Aldous Huxley 1958
Brave New World Revisited |
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Political Economy of Pharmaceutical Industry
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- consistently one of top grossing economies in world economy
- 2005- americans paid 200 billion for prescriptions promotion and ad, not R&D is its fastest growing expenditure - great percentage of new drugs are "me-too" drugs similar to drugs already available rather than new ones. |
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American Culture and Drugs
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- 5% of world population but consumes 50% or world's prescription drugs
- "good and "bad" drugs in American Culture - full time drug lobbyists outnumber senators 6 to 1 |
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Tone- Tranquilizers on Trial
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- very recent history of tranquilizers
- incredible success of anxiolytic drugs (for symptoms of anxiety, antidepressants) Miltown and Equanil in the 50s and 60s - psychiatric focus on intrapsychic conflict not chemical imbalances |
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Prescription drugs in the 50s and 60s
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- great optimism about drugs
- no stigma - "It's medicine" - "Not habit forming and even a severe dose won't kill you" |
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Healy- Antidepressant Era
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- Depression (as a disease) didn't exist 50 years ago
When anti- depressants were discovered/invented, depression was considered rare 1961- Merck bought 50,000 copies of recognizing the depressed patient and distributed it to doctors |
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Healy- Let Them Eat Prozac
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- Argues that Prozac has different effects on everyone. helps depression in some, makes some "better than well" and increases suicidal thoughts in others
- argues much of data investigating new pharmaceutical compounds unpublished and driven by business concerns |
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Greely- Ethics of Cognitive Enhancements
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- Why is it wrong to improve the function of neuronormals through medications?
- Why aren't they seen as just another way to improve ourselves? - where do we dram the line? |
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“Like all new technologies, cognitive enhancement can be used well or poorly... With this, as with other technologies, we need to think and work hard to maximize its benefits and minimize its harms.”
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Greely
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Chemicals which affect emotions
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Serotonin, Dopamine, Epinephrine, Norepinephrine, Endorphins
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Issues to consider with SSRIs
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Selective Serotonin reuptake inhibitors
- selective refers to closing serotonin pump, not selective for 'depression' - levels or serotonin cannot be measured to identify 'chemical imbalance' - new theories exist that may explain why SSRIs may help, as well as how non- pharmacological measured may help depression |
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SSRIs under new scrutiny
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One new meta-analysis suggests that “Drug–placebo differences in antidepressant efficacy increase as a function of baseline severity, but are relatively small even for severely depressed patients. The relationship between initial severity and antidepressant efficacy is attributable to decreased responsiveness to placebo among very severely depressed patients, rather than to increased responsiveness to medication.” (PLOS Medicine, 5:2:e45)
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Responses to PLoS
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- some respond studies were only 8 weeks in length
- some people respond to a combination of treatment, including talk therapy and medication - about 40% didn't respond to the first anti- depressant and needed to try another-- this was not an option in clinical trials |
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“If you don’t respond to an SSRI within 8-12 weeks, ask your doctor about trying either another drug or a larger dose. And consider talk therapy and self-help steps such as meditation or exercise in addition to, or possibly instead of, medication.”
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Consumer reports on SSRIs Aug 2008
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Resiliency- Brain
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The brain has tremendous potential for adaptation, reorganization, and resilience that is only beginning to be recognized
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Neurogenesis
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-early neurologists assumed there was no possibility of neural growth in adults
- it was assumed that neuroarchitecture was stable |
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Neurogenesis- development
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- 1960s-Improved staining and analysis techniques proved otherwise
- neurogenesis demonstrated in certain birds, fish, reptiles - in humans, neurogenesis now possible in olfactory bulbs and hippocampus - active research exploring neurogenesis in cerebral cortex |
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Neural Stem Cells
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- can give rise to different cell types including neurons, astrocytes and oligodrendocytes in the lab
- enriched environments and exercise seems to promote growth - chronic stress and sleep deprivation limits it |
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Neurogenesis and Depression
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- has been linked to the benefits of some antidepressants; lack of neurogenesis associated with depression
- consistent with research that exercise, exposure to a new &benign environment, learning and restorative sleep can help reduce depression |
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Neuroplasticity
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- refers to changes in brain architecture as a result of experience
- Castrens (2005) argues that mood may be regulated by brain plasticity not chemistry - antidepressants appear to assist in regaining neural plasticity |
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Neuroplasticity
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- suggests that experience (thinking, learning, acting) can change the brain's physical and functional anatomy
- the brain is not hard wired but can respond and adapt to changing circumstances |
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Gould's research
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- suggests that stressful environment leads to a reduction in neuronal growth
- suggests that stress changes the neuroarchitecture of the brain - hormone cortisol is bad for the brain in the long term |
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“The concept of the normal is a variation on the concept of the good. It is that which society has approved.”
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Ruth Benedict (1934)
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“The vast majority of the individuals in any group are shaped to the fashion of that culture. In other words, most individuals are plastic to the molding force of the society into which they are born…universal fact that, happily, the majority of mankind quite readily take any shape that is presented to them.”
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Ruth Benedict
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DSM- IV
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Diagnostic Statistical Manual of Disorders Statistical Manual published by the American psychiatric Association
- first published 1952, next revision 2012 |
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criticisms of DSM- IV
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- question of what is driving steady increase in number of disorders
- construct validity and issues in judging what is normal and abnormal |
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disorder
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a pathological condition of body or mind
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personality disorder
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- manifested by a chronic, habitual, maladaptive pattern of reaction that is relatively inflexible, limits the optimal use of potentialities and often provokes the responses from the environment that the subject wants to avoid
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Cross cultural considerations- DSM
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linguistic translation of terms- how do you know you're talking about the same thing?
- the DSM standardizes mental disorders in the US while previously there were different criteria in other cultures - are diagnostic categories valid across different cultures? |
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"Culture Bound Syndromes"
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- "The unfamiliar ways of being crazy"
- "recurrent, locality specific pattern of aberrant behavior and troubling experience that may or may not be linked to a particular DSM category - example of "idioms of distress" |
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Cultural formations in the DSM- IV
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Amok, nervios, billis or colera, brain fag, dhat, latah, Mal de Ojo, QiGong Psychotic reaction, Neurasthenia, Spirit possession
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Diagnosis of Schizophrenia
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2 or more of the following in one month:
- delusions, hallucinations, disorganized speech, catatonic or grossly disorganized behavior, negative symptoms - major disruption to occupational, social or self-care behaviors - continuous symptoms for 6 months |
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cross- cultural perspectives on schizophrenia
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- DSM requires 6 months of symptoms for schizophrenic label, ICD doesn't.
- "brief reactive psychosis" in relation to possession and trance states-- how does it relate? - recovery better in developing countries |
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Basic question of reification
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- if there are no concrete measures like lab tests, how do we know if personality disorders are real?
- who decides? - what are the effects of labeling in itself? |
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All these theories downgrade and even negate explanations of human behavior in terms of freedom, choice and responsibility. “Every version of historicism” writes Popper “expresses the feeling of being swept into the future by irresistible forces.” No more perfect description of the Freudian imagery of human conduct - swept into the future by the Unconscious - could be wished for..I wish only to maximize the scope of voluntaristic explanations - in other words, to reintroduce freedom, choice, and responsibility into the conceptual framework and vocabulary of psychiatry.
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Thomas Szasz
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Experiencing distress: Psychologization
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experiencing physiological distress primarily through psychological symptoms
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Experiencing distress: Somatization
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experiencing psychological distress primarily through physical symptoms
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Emotional depression
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Moods of sadness, hopelessness and inability to experience pleasure
- the idea of depression spectrum with normal sadness on one end and severe clinical depression on the other |
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DSM criteria for major depressive disorder
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have depressed mood and/or anhedonia everyday for at least 2 weeks
have at least 5 of the following: overwhelming sadness, fear or lack of emotion, diminished interest in daily activities, hopelessness, feelings of worthlessness, reproach, guilt, suicidal ideation, poor appetite, weight loss/gain, insomnia or hyperinsomnia, psycho motor agitation or retardation, loss of energy or fatigue, complaints or evidence of diminished ability to think or concentrate |
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Symptoms of Neurasthenia
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Chronic fatigue, headache, insomnia, weakness, dizziness, muscle tension, depression, anxiety, irritability
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Emotions
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- a feeling or sensation we are aware of
- last a few seconds or minutes, if longer it's mood - it's about something that matters to us - experienced as something that's happening to us, not chosen - arise automatically from appraisal of situation - desire to experience them or not can motivate much of our behavior |
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Obeysekere- Depression and Buddhism
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- does depression have cross- cultural validity
- if a culture doesn't have a category for depression as a disease, does it exist? - can depression as a disease fit into a religious perspective that accepts life as inevitably full of suffering? should it have to? |
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If the Ashanti, the Yoruba or the Sinhala of Sri Lanka were to say that certain “affects” arising out of a life condition (bereavement, loss, menopause, old age, etc.) do not constitute an illness and furthermore if these affects cannot be separated from their involvement in an existential issue (such as the nature of life) could we seriously say that the Ashant, Yoruba or Sinhala are deluding themselves and that they are in fact suffering from an illness called “depression”?
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Obeysekere
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Depression- yes it is over diagnosed
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Sadness is normal, not a disease
Low thresholds for dx challenge credibility A rush to medicate it, in the absence of a lab test to determine if you have it Labels are powerful Reduces responsibility for personal transformation |
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Depression- no it is not over diagnosed
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Dx legitimates it and reduces stigma
- allows people to get help - helpful to know other people have experienced the same - There may be a genetic/neurochemical basis - Depression can be deadly |
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Pande's perspective on psychotherapy
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- a love relationship
- help with decision making integrative process - critique of lifestyle and choices made - redress from ego- alienation and isolation |
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Ayurveda
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1000-800 B.C.E. as the "science of life", interested in disease prevention rather than treatment
- involves idea of life force, moderation, and maintaining harmony in physical, social, and spiritual relationships - Health through maintaining balance between 3 doshas - system includes 5 elements (earth, space, fire, wind, wind), 107 vital points and use of yoga, astrology, diet, hygiene, and meditation. |
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Greek and Roman
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ancient greek medical tradition began as early as 8000 B.C.E.
- nature as healing force and duty of physician was to help body restore balance and heal itself - Hippocrates one of first to rely on naturalistic rather than supernatural explanations for diseases. - also viewed humors, temperament, diet, astrology and social context as important |
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Greek Medicine: Humor
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4 humors: blood, yellow bile, black bile, phlegm
- a personality type associated with how much humor was present in individual - Important influence of Galen (130-200 C.E.) until the 16th century |
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TCM: background
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May be more than 4000 years old
- originally passed down through oral tradition, medical knowledge compiled in "the Yellow Emperor's Classic of Internal Medicine" during the Han dynasty - I Ching also important text - Each individual is a microcosm of the natural world - body is composed of chi, moisture, and blood |
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Chi
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- best translated as "vital energy" or "life force" of living things
- healthy chi moves freely in meridians (channels, pathways) in body - imbalances in chi results in deficiencies, excesses and/or stagnation -TCM seeks to restore balance of chi in body |
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Ways to influence Chi
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- Herbs, acupuncture, tui na, shiatsu, moxibustion, cupping, tai chi, chi gong, movement
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TCM- Methods of Diagnosis
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- observation (color of face and tongue, posture, manner, movement)
- listening (voice, speech, respiration, cough) - smelling (strong odor, 5 element odors) - questioning (medical history, chief complaints, body systems, appetite, diet, activity, emotions) - palpation (hara, mu and shu points) - tongue (color and coating) - pulse (thin, slippery, galloping, floating, long, flooding, big, etc.) |
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clinical signs of imbalance- deficiency
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- paler color of skin, face, tongue
- pain diminishes with heat - chronic and slow onset - weakness - fatigue |
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clinical signs of imbalance- excess
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redness of face, skin, tongue
- swelling - warmth, fever - pain diminishes with cold - pain increases with pressure - acute, sudden onset |
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TCM- 5 elements
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- metal
- fire - earth - water - wood |
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The Meridians
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Lungs and large intestine
stomach and spleen heart and small intestine Kidneys and bladder Pericardium and triple heater liver and gall bladder - conception vessel and governing vessel |
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The water element
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Water-yin (kidneys)
- rules water and bone marrow - stores jing (essence) - associated with adrenal gland water- yang bladder - purifies - eliminates - associates with pituitary gland |
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The Fire element
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Heart (fire- yin)
- houses shen - seat of emotion - rules blood and vessels - opens to the tongue SI (fire- yang) - separates pure from impure - assimilation and absorption |
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Chinese patterns and the common cold
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wind cold
- low fever, severe chills, no perspiration, sore limbs, stuffed or runny nose, itchy throat, cough with clear or white phlegm tongue: thin, white moss pulse: floating and tight |
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wind cold with dampness
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- head feels swollen as if in a sack, heavy, tired limbs, sore heavy joints
tongue: greasy, white moss pulse: soggy |
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Depression in the TCM context
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Deficient heart blood and deficient heart yin
- both associated with insufficient blood or yin to nourish the heart and shen - symptoms could include feeling of unease, disturbed sleep, excessive dreaming, insomnia, heart palpitations and forgetfulness |
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Deficient Heart Blood
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- pale tongue and thin pulse
- lusterless face - dizziness and lethargy - difficulty falling asleep but will stay asleep - associated with deficient SP chi because SP produces blood |
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Deficient Heart Yin
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- reddish tongue
- rapid, thin pulse night sweats, warm palm and sole - agitated manner - can get to sleep but awakens during the night |
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Yin
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Dark, cold, winter, inside, softer, moon, midnight
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Yang
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light, hot, summer, outside, harder, sun, midday
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religion
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system of beliefs and practices directed towards the ultimate concerns of a group
- provides connections with the sacred - helps create and maintain social cohesion - helps maintain central values of a culture - helps control anxiety about experience |
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Clifford Geertz
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-"religion as a cultural system"
- religion functions as a model of reality and a model for reality - reinforces the vision of reality as it is and the vision of how reality can be shaped, organized, and quided |
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“a system of symbols which acts to 2) establish powerful, pervasive and long-lasting moods and motivations in men by 3) formulating conceptions of a general order of existence and 4) clothing these conceptions with such an aura of factuality that 5)the moods and motivations seem uniquely realistic.”
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Clifford Geertz
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Symbols
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Something which represents something else
Key symbols of a culture - condense information - encases meaning and history - inspires scientific behavior and/or morality - transmits knowledge - transmits emotions |
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Ritual
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an activity with a high degree of formality with no utilitarian purpose
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Rites de Passage-- Arnold van Gennep
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preliminary
- preliminal, separation liminaire - limbo, communitas, betwixt and between postliminaire - incorporation, postliminal = new status for individual |
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Victor Turner
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- symbolic anthropologist
- studied Ndembu of northern Zambia discussed symbols as multivocal - the special experience of "communitas" - ritual as social drama and performance, where aesthetics can be crucial |
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“They are betwixt and between the positions assigned and arrayed by law, custom, convention, and ceremonial. As such their ambiguous and indeterminate attributes are expressed by a rich variety of symbols in the many societies that ritualize social and cultural transitions. Thus, liminality is frequently likened to death, to being in the womb, to invisibility, to darkness, to bisexuality, to the wilderness, and to an eclipse of the sun and the moon.”
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victor turner
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Why discuss religion, ritual, and belief?
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- one of their explanations is to provide explanations for illness and suffering
- to find meaning in suffering - to answer the question: why me? the intractable ethical paradox of getting what one deserves - to create order where there didn't seem to be order before |
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“How does belief work begins with “frank recognition that religious belief involves not a Baconian induction [i.e. science] from everyday experiences – for then we would all be agnostics – but rather a prior acceptance of authority which transforms the experience.”
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Geertz
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"The White Coat Effect"
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what do people assume from the white coat?
- training in medicine - license to practice medicine - membership in medical profession - specialized and generalized knowledge - power to take a medical history - allowed to obtain intimate details about person's life - examine patient's bodies - order a wide range of tests - prescribe medication - make life or death decisions - hospitalize patients, some against their will - can control those in lower social hierarchy - scientific orientation - confidentiality, reliability and efficiency - emotional and sexual detachment - cleanliness - respectability, high social status - high income |
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Symbolic Healing
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1) the heaaler has a certain worldview and a system of explanation for the problem
2) the suffering individual comes to understand their problem through this world view 3) The individual becomes attached to certain symbols of the world view 4)Is guided to therapeutic change through the manipulation of symbols 5) The individual incorporates the explanation of the illness into a new framework of understanding |
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“These experiences, however, remain intellectually diffuse and emotionally intolerable unless they incorporate one or another of the patterns present in the group’s culture” (p. 131)
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Levi- strauss
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“In a universe which strives to understand but whose dynamics it cannot fully control, normal thought continually seeks the meaning of things, which refuse to reveal their significance” (p. 135)
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Levi- Strauss
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“The treatment (unbeknownst to the therapist, naturally), far from leading to the resolution of a specific disturbance within its own context, is reduced to the reorganization of the patient’s universe in terms of psychoanalytic interpretations” (p. 136)
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Levi- strauss
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“a socially authorized translation of phenomenon.”
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Levi-strauss
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The Importance of Belief
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- for ritual and placebos to work, the person has to believe
- belief enhances the manipulation of symbols in a ritual setting - trust in one's care giver increases satisfaction with medical treatment - beliefs can heal/kill |
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What causes disease- naturalistic explanation
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the body is in disequiblirium because of impersonal natural causes
e.g. biomedicine |
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what causes disease- personalistic
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disease as a result of direct aggression through the will or power of some person or supernatural being
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What causes disease?
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- balance (hot/cold, excessive emotions, imbalance with social/natural/spiritual world)
- Issues with body (organs, blood) - Natural world - Breach of conduct - Malice - Supernatural causes |
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Traditional Ghanaian Theology
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- belief in one supreme deity and other lesser deities that play a role in everyday life
- priests and priestesses are needed to act as mediators between people and deities - mediators become possessed by deities - ceremonies often take place at shrines |
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Traditional Ghanaian Healers
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- medicinal plants have been used in traditional rituals for at least hundreds of years
- basis of the efficacy of plants is based on their supernatural connections - herbal knowledge usually passed down in lineages |
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Traditional healers
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- treat common diseases: malaria, typhoid, infertility
- often treated on "shrine days" - maladies are diagnosed and medical herbs prescribed - usually free of charge |
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Konadu- African medicine
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- african medicine as truly holistic
- separating "empirical" from "spiritual" is a false dichotomy from the west - Considers “verbal arts, dance and music as part of the full context of health and healing, which are imperative to explorations that seek to explicate indigenous African systems |
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“The approach most have taken is one where they either go data mining and unearth facts that fit their thinking and priorities, or they invent constructs to record and explain a dynamic reality in crystallized terms. The latter approach, which is frequent, embodies a reductive urge to codify carried out to such an extreme of rigidity that the unruliness of reality is too often forced into neat, mentally manipulable categories, as if such constructs can account for all emotional, physical and psychic data.”
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Warner- Lewis 2002
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“The issues of existence (or denial) of indigenous African medical systems, theories of “natural” and “supernatural” or “personalistic” disease causation and therapy, and the ubiquity of “witchcraft” as underpinning the foregoing permeate the discourse on African therapeutics and culture. In fact, these issues are the discourse. Whether one (de)emphasizes the “natural” or the “supernatural” causation and behavior or (mis)represents indigenous African healing praxis as a medical system, the aforementioned issues will remain entangled and unresolved as the quest for magic, gods, witchcraft, and supernaturally charged medicines continues.”
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Konadu
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“Many seem oblivious to the reality that indigenous African therapeutic “systems” are concerned with health and healing, primarily. In this context, disease or illness is a factor linked to both overriding concerns since healing and health occur on multiple levels and in varied areas of life that may have nothing to do with biologically determined notions of disease.”
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Konadu
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Akan Medicine
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- recognizes material and immaterial aspects of human beings
- the world "religion" has "unreconciled linguistics and cultural baggage" - the seemingly inescapable naturalistic vs personalistic or natural vs supernatural explanation is a huge reductionism of greater ideology |
