Transcultural Psychiatry.docx

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Published on 25 Sep 2013
Department
Sept, 23, 2013
Transcultural Psychiatry
-Transcultural psychiatry can be defined as being “concerned with the social and cultural determinants of
psychopathology and psychosocial treatments of the range of mental and behavioural problems in individuals,
families and human groups
-In addition to the clinical research methods of psychiatry, it draws from the disciplines of psychiatric
epidemiology, medical anthropology and cross-cultural psychology
-One of the leaders in this field is the Psychiatrist Lawrence Kirmayer, MD, from McGill University
-Kirmayer’s research has included important work with Inuit in northern Canada
-Here are some of the main points he gave at a talk:
-Biomedicine says phenomenology reflects underlying pathobiology and this can be completely characterized in
neurophysiological terms and treatment of underlying neurobiology will provide definitive intervention
-Social science says phenomenology reflects cultural contexts, knowledge, and practices and pathology is a
consequence of meaning and interpretation and changes in social response will have fundamental effects on
distress
Phenomenology:
-It aims to understand the form, quality, and texture or experience and in the DSM psychiatry reduced it to
symptoms and signs and this was driven in part by the rejection of psychoanalysis as a method and the embrace of
epidemiology
-Experience and reflection on experience is always culturally embedded and to describe experience in general
terms phenomenology must take explicit notice of culture
-Phenomenology can use neuroscience and social science to recognize aspects of experience that are not
recognized or culturally salient
Neurophenomenology:
-The structure of the nervous system and its processes give rise to specific forms and content of experience and
some example are visual phosphenes, sleep paralysis, auditory hallucinations, PTSD, depression, and grief or pain
at the loss of relationships
Cultural Neurophenomenology:
-Cultural psychiatry contrasts pathoplasticity (content/form) with pathogenesis (cause/mechanism) so we could
then try to separate the pan-cultural form or structure of depressive experience from its culture specific content
-But form and content interact and cross cultural research suggests a closer relationship in which culture shapes
experience from its inception hence we need a cultural neurophenomenology or psychiatric disorders
-This would begin with the particularity of local culturally rooted experience but could reveal universal aspects of
affliction identifiable across contexts because commonalities in biology or existential predicaments
-Cultural phenomenology requires and understanding of how experience emerges over time from a developmental
dialectic between experience and the responses of other engaged with a matrix of local meanings
-Human behaviour and pathology emerge from interactions between the nervous system and higher levels or
organization and problems may derive from faulty or maladaptive learning, problematic interactions with others,
or other social predicaments not reducible to individual neuropsychological disturbances or disorders
-Therefore a comprehensive psychiatry nosology will never be reducible to pure neuroscience unless psychiatry
chooses or is forced to neglect problems of human learning, experience, and interaction
Cultured Brains:
-The cultural programming of the brain is inscribed in its cellular machinery, connectivity, and functional
architecture and culture shapes the brain at multiple levels on different timescales:
Phylogenetic the brain is the organ of culture and one medium through which much cultural knowledge is
embodied, stored, and accessed
Epigenetic in early development we each acquire culture including language, communicative codes, skills and
behavioural repertoires that influence neural circuitry and ways of processing information
Biographical - through the trajectory of life as events are integrated into autobiographical narratives that govern
identity function
Contextual through social contexts in family, community, and institutional practices or forms of life that require
the brain to be used in specific ways
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Document Summary

Transcultural psychiatry can be defined as being concerned with the social and cultural determinants of psychopathology and psychosocial treatments of the range of mental and behavioural problems in individuals, families and human groups. In addition to the clinical research methods of psychiatry, it draws from the disciplines of psychiatric epidemiology, medical anthropology and cross-cultural psychology . One of the leaders in this field is the psychiatrist lawrence kirmayer, md, from mcgill university. Kirmayer"s research has included important work with inuit in northern canada. Here are some of the main points he gave at a talk: Biomedicine says phenomenology reflects underlying pathobiology and this can be completely characterized in neurophysiological terms and treatment of underlying neurobiology will provide definitive intervention. Social science says phenomenology reflects cultural contexts, knowledge, and practices and pathology is a consequence of meaning and interpretation and changes in social response will have fundamental effects on distress.

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