... Luxembourg British Library Cataloguing in Publication Data Church, Kathryn Forbidden Narrativ... more ... Luxembourg British Library Cataloguing in Publication Data Church, Kathryn Forbidden Narratives:Critical Autobiography as ... (Theory & Practice in Medical Anthropology & International Health; Vol.2) I. Title II ... urgent part of this process of redefinition the attempt to cut through the ...
Skip to Main Content. Wiley Online Library will be disrupted 4 Feb from 10-12 GMT for monthly mai... more Skip to Main Content. Wiley Online Library will be disrupted 4 Feb from 10-12 GMT for monthly maintenance. ...
The study of depression, drinking and suicidality has long preoccupied students of American India... more The study of depression, drinking and suicidality has long preoccupied students of American Indian life, in part because of the assumed connection between these specific forms of psychiatric distress and generalized demoralization. Given the significant variation in suicidal behavior and prevalence rates intertribally, this assumption deserves closer attention. Recently, researchers working with Western populations have sought to clarify the relationships among depression, alcohol abuse and suicidality through an explicit investigation of their comorbidity. Using data collected at the Flathead Reservation, this paper explores the degree to which the investigation of the comorbidity of these three disorders can validly reveal the relevant contours of psychopathological distress in a cross-cultural setting. The data show that while the comorbidity of problem drinking and depression can sometimes indicate severe psychopathological distress, measured in this case by suicidality, comorbi...
Over the last 20 years, the field of substance use among American Indian adolescents has come to ... more Over the last 20 years, the field of substance use among American Indian adolescents has come to be dominated by survey approaches that are unable to answer important questions about how the use of alcohol and drugs is conceptualized and meaningfully integrated in the lives of Indian teens. Without a model of adolescent alcohol use that incorporates culture, the field misapprehends the social and cultural grounding of both normal and pathological drinking, and cannot accurately differentiate between normal and pathological drinking. Traditionally, the field has relied upon either a biological model or a distress model, thus locating pathology in the biochemistry of ethanol ingestion or in psychopathological distress. However, findings from an ethnographic investigation of alcohol use among American Indian adolescents suggest that the criteria for distinguishing pathological drinking lie, instead, in the developmental and gender-specific expectations that derive from cultural values. Specifically, at a Northern Plains site, teen drinking is judged by whether drinking has begun to interfere with developmental tasks relating to the cultural values of courage, modesty, humor, generosity and family honor. We conclude with suggestions for clinicians and researchers that offer the potential to facilitate the incorporation of culture into research and practice in the field of American Indian adolescent alcohol use.
... Adolescents: Structure and Validity Christina M. Mitchell and Theresa D. O'Nell Univ... more ... Adolescents: Structure and Validity Christina M. Mitchell and Theresa D. O'Nell University of Colorado Health Sciences Center ... 1992; Huba, Wingard, & Bentler, 1981; Jessor, Van Den Bos, Vanderryn, & Costa, 1995; McGee & Newcomb, 1992; Osgood, Johnston, O'Malley, & ...
The friends and relatives of Northern Plains Vietnam combat veterans sometimes say that they can ... more The friends and relatives of Northern Plains Vietnam combat veterans sometimes say that they can recognize veterans by the "lost and faraway look" in their eyes. They say that those veterans are still in Vietnam trying to finish the war; in local terms, many combat veterans have not yet "come home." Yet some veterans have. In this paper, I trace the experiences of veterans on a Northern Plains reservation, focusing on two types of war talk and the relation of those discursive practices to a psychological, social, and moral transformation known locally as "coming home." This material reveals the symbolic, discursive, and political underpinnings of positive psychological transformation among Northern Plains combat veterans, and speaks to the question of how we construct satisfactory accounts of psychological process in cultural context.
My earlier considerations of Flathead loneliness and depressive disorder yielded an interpretatio... more My earlier considerations of Flathead loneliness and depressive disorder yielded an interpretation that emphasized the lack of necessary pathology in the Flathead experience of loneliness. In this paper I detail a shift in my thinking about the pathological character of loneliness, a shift traceable to a set of interactions that have led me away from illness experience and diagnosis to questions of treatment, intervention, and healing. I explore how this new set of questions refocused my attention-away from an exclusive preoccupation with the lonesome individual. I conclude with a reimagination of the pathological dimensions of Flathead loneliness as aspects of both group and individual health.
This review of psychiatric investigations among Native Americans opens with a discussion of the d... more This review of psychiatric investigations among Native Americans opens with a discussion of the dominant theoretical perspectives in psychiatric anthropology in order to provide an analytic framework with which to assess the substantive findings of researchers in the field. Studies of culture-specific disorders, service utilization and patient population studies, psychiatric epidemiological studies, and studies designed to test the validity of certain diagnostic instruments are scrutinized for evidence of the nature of the role of indigenous cultures in the manifestations of psychiatric disorders among these populations. The review reveals that a universalist theoretical perspective, which tends to obscure the role of local interpretations in the phenomenology of psychiatric illness, dominates this field of inquiry. Nonetheless, evidence has accumulated which indicates the importance of native understandings for a more reliable and valid explanation of the nature of mental disorder among these peoples. The inadequacies of our current knowledge are examined and suggestions for directions in future work are presented in the concluding section. Recommendations include the direct investigation of the local meanings of the signs, symptoms, and syndromes of Western psychiatry; the concentrated search for potentially unique and powerful local signs of distress; and the study of the culturallyconstituted social processes of illness.
Patient identification. Mr. A. is a 57 year-old married Chinese-American man with no previous psy... more Patient identification. Mr. A. is a 57 year-old married Chinese-American man with no previous psychiatric history who presented at the psychiatrist's office in 1989 with a three-week history of auditory hallucinations and delusions. History of present illness. The patient was in his normal state of good health until two years prior to presentation, when he stared developing intermittent acute backaches. He went to his physician and was told that he had kidney stones. Conventional medical treatment did not provide much alleviation of his symptoms, and Mr. A. gradually lost confidence in his Western-trained physician. Mr. A.'s back pain continued to flare up intermittently. After almost two years of treatment failures, Mr. A. was willing to try treatments from China. Three weeks prior to evaluation, he started practicing Qi-gong, a Chinese folk health-enhancing practice similar to Tai Chi, which consists of controlled, synchronized breathing and body movements, and is expected to have curative effects on physical illnesses. His practice of Qi-gong was intensive. Several days after starting these practices, he developed delusional and hallucinatory experiences, while he had never experienced before. These conditions persisted and intensified, interfering with his concentration, and prevented him from working as an engineer. His auditory hallucinations consisted of voices of supernatural beings communicating with him regarding how he should practice Qi-gong and delusions that he was contacting beings from another dimension. He returned to the Qi-gong masters for help, but they were unable to provide any relief. His wife, who was a registered nurse, became increasingly concerned over his inability to work. She consulted with a Caucasian psychiatrist co-worker from their health maintenance organization (HMO) who referred her husband to a Chinese-American psychiatrist in private practice. On presentation, the patient denied depressed mood,
Page 1. Telling about Whites, Talking about Indians: Oppression, Resistance, and Contemporary Ame... more Page 1. Telling about Whites, Talking about Indians: Oppression, Resistance, and Contemporary American Indian Identity Theresa D. O'Nell National Centerfor American Indian and Alaska Native Mental Health Research Department ...
... 46, 50) without describ-ing Metis refugees from the Riel Rebellions absorbed into Montana Ind... more ... 46, 50) without describ-ing Metis refugees from the Riel Rebellions absorbed into Montana Indian nations. Lakota anthropologist Beatrice Medicine pleads, at conference after conference, for studies on Indian sobriety. ... Matthew C. Gutmann. ...
... Luxembourg British Library Cataloguing in Publication Data Church, Kathryn Forbidden Narrativ... more ... Luxembourg British Library Cataloguing in Publication Data Church, Kathryn Forbidden Narratives:Critical Autobiography as ... (Theory & Practice in Medical Anthropology & International Health; Vol.2) I. Title II ... urgent part of this process of redefinition the attempt to cut through the ...
Skip to Main Content. Wiley Online Library will be disrupted 4 Feb from 10-12 GMT for monthly mai... more Skip to Main Content. Wiley Online Library will be disrupted 4 Feb from 10-12 GMT for monthly maintenance. ...
The study of depression, drinking and suicidality has long preoccupied students of American India... more The study of depression, drinking and suicidality has long preoccupied students of American Indian life, in part because of the assumed connection between these specific forms of psychiatric distress and generalized demoralization. Given the significant variation in suicidal behavior and prevalence rates intertribally, this assumption deserves closer attention. Recently, researchers working with Western populations have sought to clarify the relationships among depression, alcohol abuse and suicidality through an explicit investigation of their comorbidity. Using data collected at the Flathead Reservation, this paper explores the degree to which the investigation of the comorbidity of these three disorders can validly reveal the relevant contours of psychopathological distress in a cross-cultural setting. The data show that while the comorbidity of problem drinking and depression can sometimes indicate severe psychopathological distress, measured in this case by suicidality, comorbi...
Over the last 20 years, the field of substance use among American Indian adolescents has come to ... more Over the last 20 years, the field of substance use among American Indian adolescents has come to be dominated by survey approaches that are unable to answer important questions about how the use of alcohol and drugs is conceptualized and meaningfully integrated in the lives of Indian teens. Without a model of adolescent alcohol use that incorporates culture, the field misapprehends the social and cultural grounding of both normal and pathological drinking, and cannot accurately differentiate between normal and pathological drinking. Traditionally, the field has relied upon either a biological model or a distress model, thus locating pathology in the biochemistry of ethanol ingestion or in psychopathological distress. However, findings from an ethnographic investigation of alcohol use among American Indian adolescents suggest that the criteria for distinguishing pathological drinking lie, instead, in the developmental and gender-specific expectations that derive from cultural values. Specifically, at a Northern Plains site, teen drinking is judged by whether drinking has begun to interfere with developmental tasks relating to the cultural values of courage, modesty, humor, generosity and family honor. We conclude with suggestions for clinicians and researchers that offer the potential to facilitate the incorporation of culture into research and practice in the field of American Indian adolescent alcohol use.
... Adolescents: Structure and Validity Christina M. Mitchell and Theresa D. O'Nell Univ... more ... Adolescents: Structure and Validity Christina M. Mitchell and Theresa D. O'Nell University of Colorado Health Sciences Center ... 1992; Huba, Wingard, & Bentler, 1981; Jessor, Van Den Bos, Vanderryn, & Costa, 1995; McGee & Newcomb, 1992; Osgood, Johnston, O'Malley, & ...
The friends and relatives of Northern Plains Vietnam combat veterans sometimes say that they can ... more The friends and relatives of Northern Plains Vietnam combat veterans sometimes say that they can recognize veterans by the "lost and faraway look" in their eyes. They say that those veterans are still in Vietnam trying to finish the war; in local terms, many combat veterans have not yet "come home." Yet some veterans have. In this paper, I trace the experiences of veterans on a Northern Plains reservation, focusing on two types of war talk and the relation of those discursive practices to a psychological, social, and moral transformation known locally as "coming home." This material reveals the symbolic, discursive, and political underpinnings of positive psychological transformation among Northern Plains combat veterans, and speaks to the question of how we construct satisfactory accounts of psychological process in cultural context.
My earlier considerations of Flathead loneliness and depressive disorder yielded an interpretatio... more My earlier considerations of Flathead loneliness and depressive disorder yielded an interpretation that emphasized the lack of necessary pathology in the Flathead experience of loneliness. In this paper I detail a shift in my thinking about the pathological character of loneliness, a shift traceable to a set of interactions that have led me away from illness experience and diagnosis to questions of treatment, intervention, and healing. I explore how this new set of questions refocused my attention-away from an exclusive preoccupation with the lonesome individual. I conclude with a reimagination of the pathological dimensions of Flathead loneliness as aspects of both group and individual health.
This review of psychiatric investigations among Native Americans opens with a discussion of the d... more This review of psychiatric investigations among Native Americans opens with a discussion of the dominant theoretical perspectives in psychiatric anthropology in order to provide an analytic framework with which to assess the substantive findings of researchers in the field. Studies of culture-specific disorders, service utilization and patient population studies, psychiatric epidemiological studies, and studies designed to test the validity of certain diagnostic instruments are scrutinized for evidence of the nature of the role of indigenous cultures in the manifestations of psychiatric disorders among these populations. The review reveals that a universalist theoretical perspective, which tends to obscure the role of local interpretations in the phenomenology of psychiatric illness, dominates this field of inquiry. Nonetheless, evidence has accumulated which indicates the importance of native understandings for a more reliable and valid explanation of the nature of mental disorder among these peoples. The inadequacies of our current knowledge are examined and suggestions for directions in future work are presented in the concluding section. Recommendations include the direct investigation of the local meanings of the signs, symptoms, and syndromes of Western psychiatry; the concentrated search for potentially unique and powerful local signs of distress; and the study of the culturallyconstituted social processes of illness.
Patient identification. Mr. A. is a 57 year-old married Chinese-American man with no previous psy... more Patient identification. Mr. A. is a 57 year-old married Chinese-American man with no previous psychiatric history who presented at the psychiatrist's office in 1989 with a three-week history of auditory hallucinations and delusions. History of present illness. The patient was in his normal state of good health until two years prior to presentation, when he stared developing intermittent acute backaches. He went to his physician and was told that he had kidney stones. Conventional medical treatment did not provide much alleviation of his symptoms, and Mr. A. gradually lost confidence in his Western-trained physician. Mr. A.'s back pain continued to flare up intermittently. After almost two years of treatment failures, Mr. A. was willing to try treatments from China. Three weeks prior to evaluation, he started practicing Qi-gong, a Chinese folk health-enhancing practice similar to Tai Chi, which consists of controlled, synchronized breathing and body movements, and is expected to have curative effects on physical illnesses. His practice of Qi-gong was intensive. Several days after starting these practices, he developed delusional and hallucinatory experiences, while he had never experienced before. These conditions persisted and intensified, interfering with his concentration, and prevented him from working as an engineer. His auditory hallucinations consisted of voices of supernatural beings communicating with him regarding how he should practice Qi-gong and delusions that he was contacting beings from another dimension. He returned to the Qi-gong masters for help, but they were unable to provide any relief. His wife, who was a registered nurse, became increasingly concerned over his inability to work. She consulted with a Caucasian psychiatrist co-worker from their health maintenance organization (HMO) who referred her husband to a Chinese-American psychiatrist in private practice. On presentation, the patient denied depressed mood,
Page 1. Telling about Whites, Talking about Indians: Oppression, Resistance, and Contemporary Ame... more Page 1. Telling about Whites, Talking about Indians: Oppression, Resistance, and Contemporary American Indian Identity Theresa D. O'Nell National Centerfor American Indian and Alaska Native Mental Health Research Department ...
... 46, 50) without describ-ing Metis refugees from the Riel Rebellions absorbed into Montana Ind... more ... 46, 50) without describ-ing Metis refugees from the Riel Rebellions absorbed into Montana Indian nations. Lakota anthropologist Beatrice Medicine pleads, at conference after conference, for studies on Indian sobriety. ... Matthew C. Gutmann. ...
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