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13 - Outcomes elsewhere: course of psychosis in ‘other cultures’

from Part III - Social factors and the outcome of psychosis

Published online by Cambridge University Press:  07 December 2009

By
Kim Hopper
Edited by
Craig Morgan ,
Kwame McKenzie  and
Paul Fearon
Kim Hopper
Affiliation:
Nathan Klein Institute for Psychiatric Research and Mailman School of Public Health, Colombia University, 722 West 168th Street, Sociomedical Sciences #928, New York, NY, USA
Craig Morgan
Affiliation:
Institute of Psychiatry, King's College London
Kwame McKenzie
Affiliation:
University College London
Paul Fearon
Affiliation:
Trinity College, Dublin
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Summary

Introduction

In the mid-1970s, a fledgling anthropologist and her family landed in Dublin, ready to tackle the runes and riddles of ‘Gaelic sexuality’. Fortune had other plans. Within days of her arrival, a chance meeting with a psychiatrist convinced Nancy Scheper-Hughes to try her hand at a more consequential topic, runaway rates of schizophrenia in rural Ireland. Settling down in a seafaring village on the Dingle peninsula, she set out (as she would later put it) to ‘study madness among bachelor farmers as a projection of cultural themes’ (Kreisler, 1999). Drawing on Bateson's notion of pathogenic paradoxical communication snares (Bateson et al., 1956), she made good on the dare. Hospitalised Patrick was one of many last-born sons ‘crippled by his parents’ double-binding attempts' to keep him in reserve (single, at home, on call for their old age). Commonplace in this ‘demoralised, dying, western village’ (Scheper-Hughes, 1979, p. 190), these desperate parental gambits were late expressions of ‘the breakdown of traditional patterns of Irish familialism’. Patrick's plaintive ‘I am their dead son’ was less psychotic delusion than dreary, de facto truth.

When Saints, Scholars and Schizophrenics was published in 1979, it caused a sensation, one that has yet to fade entirely. Alternately hailed and denounced as breakthrough ethnography and heart-breaking exposé, its place in medical anthropology's canon was quickly secured. Complaints about its inaccuracies and betrayals aside, the book was plagued by a more fundamental methodological difficulty.

Keywords

cross-cultural epidemiologycross-cultural psychiatrydiscursive schoolepidemiological recordschizophreniaWHO studies
Type
Chapter
Information
Society and Psychosis , pp. 198 - 216
Publisher: Cambridge University Press
Print publication year: 2008

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