Culture Medicine and Psychiatry最新文献

{"title":"A Bit Damaged, But Not Broken\": Seed Containers, Care, and Safe Spaces for Suicidality.","authors":"Elsher Lawson-Boyd, Stephanie Lloyd","doi":"10.1007/s11013-025-09921-8","DOIUrl":"10.1007/s11013-025-09921-8","url":null,"abstract":"<p><p>The provision of care for suicidal and, perhaps especially, chronically suicidal people walks a fine line: between acknowledging a person's suffering and their desire to die, and trying to accompany them safely through their most difficult moments. In this article, we explore what it means to receive and provide \"safe care,\" as traced through the words of people with lived experiences of suicide. Our data comes from 18 interviews with members of an Australian lived experience of suicide organization, which included people with lived experience of chronic suicidal ideation, the bereaved, peer workers, and Safe Space volunteers. Drawing on the anthropology of care and aligned psychoanalytic theory, particularly Emily Yates-Doerr's (Anthropol Human 45:233-244, 2020) consideration of the seed container and Donald Winnicott's notion of holding, we unpack how suicidality is experienced, what makes care safe, and how notions of holding space for people are becoming anchored in emerging \"Safe Spaces.\" Interview participants called for a paradigmatic shift in suicide care: in contrast to \"negative\" conceptions (Baril, in: Disability Stud Q 40:1-41, 2020), what arose in their stories were appeals for present-focused and engaged support where emotion, turmoil, and sorrow could be weathered alongside the listener. Thus, safe care works within infrastructures of care to neutralize-not diminish, prevent, or fix-suicidality, and to hold it within a space of concern so that it may transform.</p>","PeriodicalId":47634,"journal":{"name":"Culture Medicine and Psychiatry","volume":" ","pages":"1106-1125"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733972","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":"\"Anyone Else Struggling with Work-Genocide Balance?\" Exploring the Psychological and Social Impact of Collective Annihilation in Gaza.","authors":"Federica Cavazzoni, Ala' Mustafa, Cindy Sousa, Ola H Abuward, Mona Ameen Nofal, Guido Veronese","doi":"10.1007/s11013-025-09953-0","DOIUrl":"10.1007/s11013-025-09953-0","url":null,"abstract":"<p><p>This study investigates the psychological and social impact of the ongoing colonial violence in Gaza, both on the local population and on distant witnesses. Drawing on 30 testimonies collected between November 2023 and June 2024, the research captures the lived experiences from two distinct groups: 15 Palestinian participants living in the Gaza Strip, and 15 mental health professionals (including psychotherapists and academics) based in Europe. Using phenomenological and thematic analysis, the findings reveal the profound effects of genocidal violence on mental health, emotional resilience, and meaning-making processes. For Palestinians, daily exposure of bombardment, displacement, and systemic dehumanization undermines personal and collective agency, resulting in emotional numbness, anger, and alienation. Witnesses from European contexts reported helplessness, disorientation, and moral injury, often struggling with their perceived complicity in global systems of oppression. The study challenges conventional trauma frameworks, emphasizing the need to conceptualize colonial trauma as continuous, collective, and politically rooted. It argues for integrating social and political dimensions into psychological approaches to trauma, and highlight the ethical and political importance of bearing witness. Ultimately, the paper calls for a transnational process of collective healing and solidarity, aimed at dismantling the structural foundations of violence and dehumanization.</p>","PeriodicalId":47634,"journal":{"name":"Culture Medicine and Psychiatry","volume":" ","pages":"1372-1393"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12745302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349179","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":"A Time to Die: Mexican Life Debates and the Paradox of Choice in Palliative Care.","authors":"Elyse Ona Singer, Norma Alicia Ordóñez Vázquez","doi":"10.1007/s11013-025-09937-0","DOIUrl":"10.1007/s11013-025-09937-0","url":null,"abstract":"<p><p>Enduring contests between church, state, and individual control over the body in Mexico have recently manifested in a contentious \"life debate\" over the definition and ethics of \"dignified death\" (Roberts in God's laboratory: assisted reproduction in the Andes. University of California Press, 2012). In 2008, Mexico City passed the Advance Directive Law, authorizing the right to refuse or withdraw life-sustaining treatment and affording palliative care services to the terminally ill through public hospitals. While these measures have ostensibly ameliorated end-of-life suffering, a growing movement of activists argues that the law falls short. They advocate for the legalization of assisted dying as central to \"dignified death\" despite resistance from the Catholic hierarchy and its political allies. Drawing on one year of research in Mexico's National Cancer Institute, we analyze the place of public palliative care clinicians in this fraught debate, parsing their model of care, which is predicated on surrendering to the body's preordained rhythms of life and death. We argue that this orientation gives rise to a paradox at the heart of public palliative care, which simultaneously expands end-of-life choices while making certain choices inconceivable. Our argument has implications for anthropological theories of human agency and choice, provoking complex questions about who is authorized to draw boundaries around life and death.</p>","PeriodicalId":47634,"journal":{"name":"Culture Medicine and Psychiatry","volume":" ","pages":"1286-1305"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12745308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233857","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":"But My Mother Is Beautiful: Understanding Body-Focused Anxiety Among Chinese Young Women as an Embodiment of Intergenerational Trauma.","authors":"Hua Wu","doi":"10.1007/s11013-025-09946-z","DOIUrl":"10.1007/s11013-025-09946-z","url":null,"abstract":"<p><p>Body-focused anxiety refers to a wide range of negative emotional and social experiences centered around discontent with one's own body. This widely recognized phenomenon is mainly experienced by women across different contexts, often resulting from gendered socialization (Becker (1995) Body, self, and society: the view from Fiji. University of Pennsylvania Press, p. 2016). In modern Chinese society, it is important to understand these complex experiences within the quickly changing social landscape and ideas of womanhood. This study goes beyond clinical settings and the scope of mental illness (such as disordered eating or body dysmorphia) to include a variety of embodied experiences, including gender-related stress, negative self-awareness, and struggles in intimate relationships in the daily lives of young Chinese women. To grasp the current generation's body-focused anxiety, this research suggests examining it through the lens of intergenerational trauma, particularly the embodiment of patriarchal injustice reflected in the deeply connected relationship between Chinese mothers and daughters. Over 7 years, this article presents person-centered ethnography to show that some of the most intense body-focused anxiety among young women is an intergenerationally shaped existential crisis rooted in their mothers' upbringing within an explicit son-preference culture. As part of the intergenerational trauma, the body-focused anxiety is driven by (1) the mothers' unresolved girlhood trauma of being \"born into the wrong gender\"; (2) the desire to fulfill social obligations, which reflects both intergenerational trauma and the gender-specific challenges faced in a changing patriarchy. This analysis emphasizes that body-focused anxiety is not just a reaction to current social pressures, but a reflection of identities shaped across generations. It reveals that \"becoming women\" in a specific cultural context is transhistorical and closely linked to unresolved traumas from previous generations. Manifesting in different forms, understanding young women's body-focused anxiety from an intergenerational trauma perspective highlights how ongoing social forces are embodied even as cultural norms and social structures change.</p>","PeriodicalId":47634,"journal":{"name":"Culture Medicine and Psychiatry","volume":" ","pages":"1455-1477"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12745317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304073","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":"Ronaldo on the Clapham Omnibus: Complex Recoveries in Complex Psychosis.","authors":"Henry J Whittle","doi":"10.1007/s11013-025-09931-6","DOIUrl":"10.1007/s11013-025-09931-6","url":null,"abstract":"<p><p>Dominant cultural framings of recovery in psychosis describe a process of increasing social connection, community integration, identity reclamation, and hope. Drawing on 6 months of ethnographic fieldwork on a psychiatric rehabilitation ward for 'complex psychosis' in London, I consider what we might learn from recoveries that appear not to follow this trajectory. My primary case study, of a man diagnosed with treatment-resistant schizoaffective disorder who identifies with/as the famous ex-footballer Ronaldo, interrogates the social implications of his attempts to 'mask' his identity while on leave from the hospital to avoid \"caus[ing] trouble\"-strategically embodying, in effect, the fictitious 'ordinary' person denoted by the English idiom the man on the Clapham omnibus. I argue that his complex recovery, built on a trial-and-error process of retreat from social connection and caution towards hope, reflects a degree of clinical complexity seldom acknowledged outside psychiatric rehabilitation. Engaging with more nuanced anthropological theories of recovery in psychosis, my analysis illuminates how the time, space, and relative safety of a lengthy involuntary hospital admission proved necessary for his complex recovery to unfold. This insight contrasts with the dominant operationalisation of recovery in contemporary mental health systems, which seems to be fuelling disinvestment in such rehabilitative admissions.</p>","PeriodicalId":47634,"journal":{"name":"Culture Medicine and Psychiatry","volume":" ","pages":"947-970"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733975","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":"Diagnosing Prolonged Grief Disorder: Cultural Challenges to the DSM-5-TR Criteria.","authors":"Brianne S Moore, João P da Silva, Miguel Farias","doi":"10.1007/s11013-025-09940-5","DOIUrl":"10.1007/s11013-025-09940-5","url":null,"abstract":"<p><p>Prolonged grief disorder (PGD) was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) in 2022. It proposed that after persisting in an acute manner for more than a year, grief becomes pathological. This article explores cultural challenges to the application of the DSM-5-TR in diagnosing PGD and discusses culturally sensitive approaches to addressing grief pathology. We have identified three key dimensions that present cultural challenges to the PGD diagnosis: duration of mourning, intensity of emotions, and anomalous cognitions. While the DSM-5-TR clarifies that PGD symptoms must exceed contextual norms (Criterion E), here we critically assess the relevance and limitations of PGD from a cultural perspective and discuss the role rituals and traditional healing might play in grief interventions.</p>","PeriodicalId":47634,"journal":{"name":"Culture Medicine and Psychiatry","volume":" ","pages":"1504-1516"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884108","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":"The Knowledge of Neglect: Reflections of Mothers Experiencing Homelessness in Dublin on Social Care Interventions Involving Their Children.","authors":"Hannah Lucey","doi":"10.1007/s11013-025-09947-y","DOIUrl":"10.1007/s11013-025-09947-y","url":null,"abstract":"<p><p>This paper examines the reflections on caregiving provided by a group of Irish mothers who were homeless, struggling with addiction, and had lost primary custody of their children. Drawing on Das's (Slum acts. Polity Press, Cambridge, 2022) discussion of 'inordinate knowledge', or knowledge of real-life and morally dubious scenarios that resist attempts at resolution through philosophical reasoning, the paper explores how women in these situations grappled with the realisation of having neglected their children. I demonstrate my interlocutors' ongoing ethical self-evaluations and continued attempts to make amends for their earlier caregiving lapses, with the limited resources at their disposal. In so doing, I demonstrate how my interlocutors' yearning towards their children, as revealed through the process of reflexive caregiving action, became entwined with their trajectories through homelessness and addiction in Dublin. At the same time, I probe the limits of anthropologists' proclivity for contextualising and rationalising unsettling caregiving behaviours. Instead, inspired by my interlocutors' unflinching self-evaluation, this paper explores the moral quandaries which emerge as a result of care's polyvalent nature by asking if we can ever reconcile a mother's attempt to atone for her faltering engagement with caregiving with her child's experience of neglect.</p>","PeriodicalId":47634,"journal":{"name":"Culture Medicine and Psychiatry","volume":" ","pages":"1437-1454"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12745299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304075","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":"Connections on the Line: Interactions Between Care, Expertise, and Anonymity in a Suicide Hotline in Hong Kong.","authors":"Nicole Zhong, Zhiying Ma","doi":"10.1007/s11013-025-09954-z","DOIUrl":"10.1007/s11013-025-09954-z","url":null,"abstract":"<p><p>Suicide hotlines as a form of teletherapy have been associated since conception with questions of non-consensual reporting and intervention. This article investigates how suicide hotline volunteers in Hong Kong engaged with expertise and anonymity to perform care. The analysis consists mostly of semi-structured interviews with volunteers at a multilingual suicide hotline in Hong Kong. Firstly, we deconstruct expertise in hotline care-volunteers separated enacting expert knowledge from authority to simultaneously respond to cultural nuances in caller expectations toward authority and perform non-interventive care. Secondly, we show how anonymity within hotlines creates obscurations between callers and volunteers that raises the stakes to volunteers' decision-making in care. When volunteers embraced uncertainty and committed to providing confidentiality and control to callers, anonymity facilitated the prioritization of caller choice, even in death. Finally, we reflect on how acts of volunteers recognizing and forming connections with callers can demonstrate how we can meet each other, bridge divides, and connect as strangers in the city.</p>","PeriodicalId":47634,"journal":{"name":"Culture Medicine and Psychiatry","volume":" ","pages":"1349-1371"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12745309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309538","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":"Seasoned Veterans of the Waiting Room: Stories from Working-Class Neighbourhoods of Delhi, India.","authors":"Kavita Dasgupta","doi":"10.1007/s11013-025-09934-3","DOIUrl":"10.1007/s11013-025-09934-3","url":null,"abstract":"<p><p>Taking seriously the idea that liberation medicine should include, or even start from, the perspectives of those who are at the margins of the current medical system, this article draws on the perspective provided by a group of working-class writers who inhabit these margins, through an ethnographic story about medical failure and radical care. The story follows a middle-aged couple, Farid and Shakeela, residents of a working-class neighbourhood in Delhi, who travel to one of the largest public hospitals in the city for the delivery of their baby. Upon arrival, they encounter a hospital as a separate world, a space with its own rules and language, with maze-like pathways. Through the experiences of this couple, this article sheds light on some questions that help to theorize liberation medicine: In a medical system which is vast and overwhelming, does a labourer have any agency in finding a toe hold, or are they completely helpless and dependent on doctors, nurses, and technicians? Doctors diagnose an illness; however, who defines sickness? What makes a daily wage earner determine the condition of their health? Through reading this story, as well as the pedagogy of its writers, this article sheds light on the significance of networks of care which are easy to overlook whilst also calling for perfect institutions.</p>","PeriodicalId":47634,"journal":{"name":"Culture Medicine and Psychiatry","volume":" ","pages":"1002-1015"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12745300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145641160","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":"\"My Body Will Remember What My Mind Wants to Forget\": Towards a Bio-cultural Vulnerability Model of Veteran Multi-morbidity.","authors":"Shaddy K Saba, Kathryn Bouskill, Angeles Sedano, Benjamin Henwood, Eric R Pedersen, Aysha Allahverdiyeva, Carl A Castro, Jordan P Davis","doi":"10.1007/s11013-025-09925-4","DOIUrl":"10.1007/s11013-025-09925-4","url":null,"abstract":"<p><p>Military veterans have high rates of posttraumatic stress disorder (PTSD) along with multi-morbid problems, including physical pain and problematic substance use. The etiology of multi-morbid problems likely involves both military experiences and culture. Qualitative research can build understanding of vulnerability for multi-morbid problems. Participants were US veterans with PTSD symptoms, pain, and problematic substance use (n = 20). Qualitative interviews focused on military experiences, multi-morbid problems, and coping. Transcripts were analyzed to develop an explanatory model of multi-morbidity. Military experiences that left veterans vulnerable to PTSD and multi-morbid problems included (1) military deployments, (2) specific discrete events, and (3) the accumulation of stressors over time. In the aftermath of these experiences, military cultural factors that increased vulnerability included (4) the significance of losing one's physical and mental fitness, (5) a tendency to ignore or minimize pain, (6) discrepancies between military and civilian culture, (7) military drinking norms, and (8) treatment stigma. Military cultural factors that decreased vulnerability included (9) camaraderie and (10) service. Military culture moderated the impact of challenging experiences to influence participants' vulnerability for PTSD and multi-morbid problems, in line with bio-cultural models of health. Clinical assessments and treatments should incorporate the range of military cultural risk and protective factors, and veterans' perceptions of how these factors influence their health.</p>","PeriodicalId":47634,"journal":{"name":"Culture Medicine and Psychiatry","volume":" ","pages":"1176-1195"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12981360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838252","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}