Overview of the impact of culture on mental health: the importance of meaning and hope

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Overview of the impact of culture on mental
health the importance of meaning and hope

• Philip Thomas
• Professor of Philosophy Diversity Mental Health
• International School for Communities Rights and
  Inclusion
• University of Central Lancashire
• Preston PR1 2HE
• U.K.

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Outline of talk

• What do we mean by culture.
• Describe recent changes in how we think about
  culture and the relationship between culture and
  identity.
• Outline the cultural origins and assumptions of
  technological psychiatry as a way of
  understanding madness.
• Examine the limitations of technological
  psychiatry in understanding madness and distress.
• Examine how culture and meaning are central to
  understanding madness.

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What is culture? 1 - Content

• Language, custom and tradition
• Belief, faith and spirituality
• Values and morals
• Art, literature, music aesthetics
• History and place

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What is culture? 2 - Functions

• Culture is that aspect of our shared humanity
  that
• binds us together and
• creates human difference and diversity.
• Through the particularity of history and
  geography, culture binds us to existential time
  and space.
• In this way, culture is a key determinant of
  personal identity who I am as a person.
• Culture constitutes the referrents, signs and
  symbols that bring meaning into our lives.

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Increasing Complexity of Culture

• Migration and Mobility
• The media and new information technology
• The end of colonialism
• The crisis of modernity
• Cultural Psychiatry in a Creolizing World
  Questions for a New Research Agenda. Bibeau, G.
  (1997) Transcultural Psychiatry, 34, 9 - 41.

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Cogito ergo sum I think therefore I am
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• "... the enterprise of the age of reason,
  gaining authority from the mid-seventeenth
  century onwards, was to criticise, condemn and
  crush whatever its protagonists considered to be
  foolish or unreasonable.... And all that was so
  labelled could be deemed inimical to society or
  the state - indeed could be regarded as a menace
  to the proper workings of an orderly, efficient,
  progressive, rational society"
• (Porter, 1987, pgs 14-15).

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Psychiatry and the European Enlightenment
Focus on Self
Importance of reason
Preoccupation with depth and interiority
Need for a reasonable society
Emergence of Technological thinking
Exclusion of unreason
Discourses of interior
Technological approaches
Great confinement
Quest for individual truth
Psychiatry
Figure 1 in Postpsychiatry, Bracken, P.
Thomas, P. (20057)
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Science and Human Experience
Helmholtz
Auguste Comte
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HAD Scale Scoring Sheet Name ____________________
____________ Date___/___/______ This
questionnaire is designed to help your advisor
to know how you feel. Read each item and place a
firm tick in the box opposite the reply which
comes closest to how you have been feeling in the
past week. Dont take too long over your
replies your immediate reaction to each item
will probably be more accurate than a long
thought out response. Tick only one box in each
section I feel tense or wound up I feel as
if I am slowed down
A
D
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Karl Jaspers
Edmund Husserl
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My glass is full of water.
My heart is full of sadness.
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My glass is full of water.
Ludwig Wittgenstein
My heart is full of sadness.
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• "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 experimental science in search of
  law but an interpretative one in search of
  meaning."
• (Geertz, 19735)

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• Bracken, P. Thomas, P. (2005) Postpsychiatry
  Mental Health in a Postmodern World. Oxford,
  Oxford University Press.
• Lapsley, H., Nikora, L. Black, R. (2002) Kia
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  Mental Health Commission, Wellington NZ, Accessed
  28/20/04 at http//www.mhc.govt.nz/publications/20
  02/Kia_Mauri_Tau.pdf 2004.
• Onken, S., Dumont, J., Ridgway, P., Dornan, D.
  Ralph, R. (2002) Mental Health Recovery What
  Helps and What Hinders? A National Research
  Project for the development of Recovery
  Facilitating System Performance Indicators.
  National Technical Assistance Center for State
  Mental Health Planning, National Association of
  State Mental Health Programme Directors, USA.
  Accessed 04/11/03 http//www.nasmhpd.org/general_f
  iles/publications/ntac_pubs/reports/MHSIPReport.pd
  f
• Tooth, B., Kalyanasundaram, V., Glover, H.
  Momenzadah, S. (2003) Factors consumers identify
  as important to recovery from schizophrenia.
  Australasian Psychiatry, 11 (supplement) 70 77.
• Topor, A. (2001) Managing the Contradictions
  Recovery from Severe Mental Disorders. Stockholm
  Studies of Social Work, 18. Stockholm, Stockholm
  University Press.
• Thornhill, H., Clare, L. May, R. (2004)
  Escape, Enlightenment and Endurance Narratives
  of recovery from psychosis. Anthropology and
  Medicine, 11, 181 199.