{"title":"The Evolution of Symbolic Thought: At the Intersection of Schizophrenia Psychopathology, Ethnoarchaeology, and Neuroscience.","authors":"Matteo Tonna","doi":"10.1007/s11013-024-09873-5","DOIUrl":"10.1007/s11013-024-09873-5","url":null,"abstract":"<p><p>The human capacity for symbolic representation arises, evolutionarily and developmentally, from the exploitation of a widespread sensorimotor network, along a fundamental continuity between embodied and symbolic modes of experience. In this regard, the fine balancing between constrained sensorimotor connections (responsible for self-embodiment processing) and more untethered neural associations (responsible for abstract and symbolic processing) is context dependent and plastically neuromodulated, thus intersubjectively constructed within a specific socio-cultural milieu. Instead, in the schizophrenia spectrum this system falls off catastrophically, due to an unbalance toward too unconstrained sensorimotor connectivity, leading to a profound distortion of self/world relation with a symbolic activity detached from its embodied ground. For this very reason, however, schizophrenia psychopathology may contribute to unveil, in a distorted or magnified way, ubiquitous structural features of human symbolic activity, beneath the various, historically determined cultural systems. In this respect, a comparative approach, linking psychopathology and ethnoarchaeology, allows highlight the following invariant formal characteristics of symbolic processing: (1) Emergence of salient perceptive fragments, which stand out from the perceptual field. (2) Spreading of a multiplicity of new significances with suspension of common-sense meaning. (3) Dynamic and passive character through which meaning proliferation is experienced. This study emphasizes the importance of fine-grained psychopathology to elucidate, within a cross-disciplinary framework, the evolutionarily and developmental pathways that shape the basic structures of human symbolization.</p>","PeriodicalId":47634,"journal":{"name":"Culture Medicine and Psychiatry","volume":" ","pages":"900-917"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11570560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Stubborn Families: Logics of Care of a Family Member with Borderline Personality Disorder.","authors":"Maureen O'Dougherty","doi":"10.1007/s11013-024-09853-9","DOIUrl":"10.1007/s11013-024-09853-9","url":null,"abstract":"<p><p>This study conducted in-depth, largely unstructured interviews with 31 involved family members in a metropolitan area of the United States (US) Midwest on their experiences of BPD in a close relative. Narrative analysis employing concepts from anthropology (the logic of care and family assemblage) was used to examine the nature and quality of care practices and identify human, environmental, and cultural supports needed for family recovery. Findings indicate that these US family caregivers provided intensive and extensive care over the long term. They acted in situations of risk to their relative, and often disconnected from professional support. Parents labored under unforgiving normalizations: judgments (real or perceived) of not properly raising or \"launching\" their children and norms of parental self-sacrifice. The dearth of housing options for the young person hindered recovery. While duly recognizing the care practices provided by family members for a relative with BPD, I argue that there is a significant omission. Our conceptualizing of supports for family members of a relative with BPD needs to encompass supports for their own recovery. Respite, mental health care for caregivers, housing, support groups, and collaborative care (with professionals, peers and family members) could productively assist recovery of all family members.</p>","PeriodicalId":47634,"journal":{"name":"Culture Medicine and Psychiatry","volume":" ","pages":"768-791"},"PeriodicalIF":16.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Dhat Syndrome East and West: A History in Two Acts.","authors":"Diederik F Janssen","doi":"10.1007/s11013-024-09874-4","DOIUrl":"10.1007/s11013-024-09874-4","url":null,"abstract":"<p><p>The intriguing story of dhat syndrome is that of medical modernity (psychiatry, clinical sexology) declaring medical premodernity (Ayurvedic concepts of semen loss) as its object. The early history and prehistory of this \"culture-bound\" diagnosis help understanding it as a dynamic confrontation of local, shifting knowledges. For instance, semen loss anxiety was an established motif both in European early twentieth-century psychoanalysis and again in several Indian psychodynamic texts of the 1960s. Moreover, it became problematically tied to notions of \"Indian character\". Little realized is that European venereologists were dealing with much comparable clinical presentations since the late eighteenth century, often resolving them in strikingly similar ways. For centuries, European proto-endocrinological ideas tied masculinity to the absorption and recirculation of semen, informing popular conceptions of \"semen loss\" (spermatorrhea) much comparable to those driven by dhatu physiology, dovetailing in colonial-era medicine. Expressive of growing controversy concerning this physiology after the mid-eighteenth century, a leitmotif of exaggerated fears tied to both \"quacks\" and proselytizing leading authorities such as Tissot and Lallemand, informed diagnoses of \"tabes imaginaria\", \"spermatophobia\", and \"imaginary spermatorrhea.\"</p>","PeriodicalId":47634,"journal":{"name":"Culture Medicine and Psychiatry","volume":" ","pages":"918-939"},"PeriodicalIF":16.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Chinese Dance Therapy Framework.","authors":"Wolfgang Mastnak","doi":"10.1007/s11013-024-09875-3","DOIUrl":"10.1007/s11013-024-09875-3","url":null,"abstract":"<p><p>Genuine Chinese dance therapy is in the ascendant and psychiatric approaches that involve a broad spectrum of principles such as ontological identity, social inclusion and collective support, aestheticisation and expressive catharsis, symbolic exorcism, trance and Buddhist mindfulness. Its models are based on a wealth of Chinese dance genres originating from various dynasties as well as cultural traditions of ethnic minorities. Due to different epistemological backgrounds of Western diagnostic manuals and traditional Chinese views of mental diseases, complex understanding of pathologies and therapeutic dynamics is needed. Therefore, this opinion piece suggests a theoretical framework that encourages interdisciplinary approaches as well as inclusive transcultural psychiatry and related philosophy of science.</p>","PeriodicalId":47634,"journal":{"name":"Culture Medicine and Psychiatry","volume":" ","pages":"961-967"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Re-thinging Embodied and Enactive Psychiatry: A Material Engagement Approach.","authors":"Lambros Malafouris, Frank Röhricht","doi":"10.1007/s11013-024-09872-6","DOIUrl":"10.1007/s11013-024-09872-6","url":null,"abstract":"<p><p>Emerging consensus among enactivist philosophers and embodied mind theorists suggests that seeking to understand mental illness we need to look out of our skulls at the ecology of the brain. Still, the complex links between materiality (in broadest sense of material objects, habits, practices and environments) and mental health remain little understood. This paper discusses the benefits of adopting a material engagement approach to embodied and enactive psychiatry. We propose that the material engagement approach can change the geography of the debate over the nature of mental disorders and through that help to develop theoretical and practical insights that could improve management and treatment for various psychiatric conditions. We investigate the potential role of Material Engagement Theory (MET) in psychiatry using examples of aetiologically different mental illnesses (schizophrenia and dementia) in respect of their shared phenomenological manifestations, focusing particularly on issues of memory, self-awareness, embodiment and temporality. The effective study of socio-material relations allows better understanding of the semiotic significance and agency of specific materials, environments and technical mediations. There is unrealised potential here for creating new approaches to treatment that can broaden, challenge or complement existing interventions and practices of care.</p>","PeriodicalId":47634,"journal":{"name":"Culture Medicine and Psychiatry","volume":" ","pages":"816-839"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11570561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Psychiatric Experiments with \"Community\" Under Dictatorship and Authoritarianism: The Case of the Protected Commune Experience, 1980-1989.","authors":"Cristian Montenegro","doi":"10.1007/s11013-024-09868-2","DOIUrl":"10.1007/s11013-024-09868-2","url":null,"abstract":"<p><p>In Chile, a long and oppressive military regime (1973-1990) dismantled emergent initiatives for the deinstitutionalisation of psychiatric care, imposing a neoliberal constitution that opened public services to market forces and limited the state's role in health and social care. After being associated with communism and socialism, community-based mental health work was banned, and socialist psychiatrists were silenced through torture or exile. However, some therapeutic initiatives persisted, such as the \"Protected Commune\" (PC) initiative within the El Peral psychiatric asylum. The PC attempted to mimic a real town inside the asylum's gated perimeter. It featured an ecumenical chapel, a school, and various \"council\" departments like recreation, education, waste, economy, and health. Paths received names, wards became districts, and patients and workers were assigned new, democratic roles, all while the authoritarian regime entirely controlled the \"outside\" world. The initiative ceased with the return of democracy in 1990. Deemed an eccentric and negligible episode, the PC is often seen as an interruption to the radical community-based experiences of the pre-dictatorial era. Drawing on archival research and oral history interviews with participants, this paper examines how the PC harnessed the notion of community to navigate the complex socio-political landscape of the dictatorship. Differing from established accounts of the political uses of psychiatry under authoritarianism, the study positions the PC as a prism for understanding the contradictory ways in which the idea of 'community' has been able to transcend radically opposed social and political regimes, becoming a core feature in the vocabulary of mental health reform, despite its ambiguities.</p>","PeriodicalId":47634,"journal":{"name":"Culture Medicine and Psychiatry","volume":" ","pages":"677-698"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11570558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Infertility as Trauma: Understanding the Lived Experience of Involuntary Childlessness.","authors":"Cristina Archetti","doi":"10.1007/s11013-024-09871-7","DOIUrl":"10.1007/s11013-024-09871-7","url":null,"abstract":"<p><p>Infertility, to those who are affected by it, is much more than whether one manages (or not) to have a child: it can be a traumatizing experience. Based on a clinical case study that involved one-to-one psychotherapy sessions and semi-structured interviews with six involuntarily childless women living in Norway, this article develops the argument that there is a need to treat infertility as trauma, both conceptually and from the perspective of therapeutic practice. The analysis contributes to our understanding of trauma as a disruptive event that erodes a person's moral agency. It does so by outlining conceptual and therapeutic tools that illuminate what happens in the psyche as a result of the trauma: they help explaining why the moral agency of different individuals is damaged to different extents, and how therapy can repair it. In relation to the issue of involuntary childlessness, the analysis shows where infertility fits within one's traumabiography-a map of the way adverse experiences over the life-course have affected one's psyche and behavior-both as traumatizing in itself and connected to previous traumas. This understanding enables more effective therapeutic support and better care for many individuals whose long-term suffering would otherwise remain unacknowledged and untreated.</p>","PeriodicalId":47634,"journal":{"name":"Culture Medicine and Psychiatry","volume":" ","pages":"940-960"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11570559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Living Dead: Trans Cooperations with Mad Necropolitics and the Mad Trans Coalitions that Might Replace Them.","authors":"Wren Ariel Gould","doi":"10.1007/s11013-024-09884-2","DOIUrl":"https://doi.org/10.1007/s11013-024-09884-2","url":null,"abstract":"<p><p>Trans subjectivities continue to be included in major compendia of mental illness, despite recent moves to depathologize \"cross-gender identification.\" Regardless, the inclusion of \"gender dysphoria\" is often framed as a formal mechanism to support access to gender affirming care as transgender subjectivities are re-conceptualized as part of sex/gender diversity and away from madness. The latter permits trans individuals to evade sanist oppressions. However, moves to disassociate from mad individuals also often serve to condone sanism. For instance, a contemporary policy landscape often sees transgender advocates arguing for the \"medical necessity\" of gender affirming care for gender dysphoria as a \"recognized medical condition,\" thereby skirting the inclusion of gender dysphoria as a psychiatric condition and implying that gender dysphoria carries a special ontological status that separates it from madness (reified as \"mental illness\"). More though, this framework endorses material violences toward mad individuals that are often advanced via the workings of the state to consign marginalized constituents to death by withholding the means of life, i.e., necropolitics. In the following, I argue that trans disassociations from madness often endorses or assents to mad necropolitics. Drawing from Mbembe's (Necropolitics. Duke University Press, Durham, 2019) framework, I suggest that medicalizing trans narratives, despite being used to object to anti-trans laws in contemporary context, ideologically support mad \"death worlds\" organized through the U.S.A. welfare state and prison industrial complex. However, I also suggest alternative strategies, i.e., intersectional collaboration, that may uplift mad and/or trans communities.</p>","PeriodicalId":47634,"journal":{"name":"Culture Medicine and Psychiatry","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Killing Two Birds with One Stone: Mandatory Therapy and the Prevention of Sex Crime in France.","authors":"Eléonore Rimbault","doi":"10.1007/s11013-024-09882-4","DOIUrl":"https://doi.org/10.1007/s11013-024-09882-4","url":null,"abstract":"<p><p>This paper considers the development of new clinical and medical practices in the early 2000s in France, after the adoption of legal reforms aiming at the prevention of sexual infractions and the protection of minors. The paper explains how the reform led to the creation of a new form of punishment for sexual offenders, l'obligation de soin (therapeutic obligation), which can be described as long-term mandatory therapeutic monitoring. This paper offers an analysis of the implementation of this measure from the standpoint of the specialized mental health care unit which were entrusted the mission of caring for the new group of convicted patients, i.e., patients sentenced to undergo mandatory therapy, after this legal reform. In the new regime these mandatory therapies created, clinicians are tasked to combine their conventional mission of care for the patient in the present, with the judicial mandate of detecting and preventing the patient's relapse qua recidivism in the future. Mobilizing ethnographic examples that evidence the way clinical care comes to encompass a penal mandate of long-term surveillance of convicted patients, I argue that the dual injunction of procuring care while preventing relapse-recidivism constrains the psychodynamic forms of clinical intervention deployed by French clinicians, realigns both psychiatric and clinical interventions along penal lines, and revives interest in some of the diagnostic categories and aims of criminal psychiatry which were important for the development of psychiatry in France.</p>","PeriodicalId":47634,"journal":{"name":"Culture Medicine and Psychiatry","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Thanato-technics: Temporal Horizons of Death and Dying.","authors":"Dylan T Lott","doi":"10.1007/s11013-024-09877-1","DOIUrl":"https://doi.org/10.1007/s11013-024-09877-1","url":null,"abstract":"<p><p>Advances in end-of-life technologies increasingly destabilize received notions of personhood, identity, and ethics. As notions of personhood and identity within such systems are made to conform to discrete, binary and less fluid categories, some in the West have sought guidance in the techniques and views related to the dying process cultivated in other cultures, particularly Tibetan Buddhism. This article considers such dynamics as they unfolded in research focused on the postmortem bodies of Tibetan Buddhist practitioners in India. This article introduces the term thanato-technics to highlight the temporalities, imaginary or otherwise, evoked, enabled, and invested through the use of technologies to ascertain or conjecture about the intrasubjectivity of the dead and dying.</p>","PeriodicalId":47634,"journal":{"name":"Culture Medicine and Psychiatry","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}