Patients and Healers in the Context of Culture: An Exploration of the Borderland Between Anthropology, Medicine, and Psychiatry

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University of California Press, 1980 - Medical - 427 pages
From the Preface, by Arthur Kleinman:Patients and Healers in the Context of Culture presents a theoretical framework for studying the relationship between medicine, psychiatry, and culture. That framework is principally illustrated by materials gathered in field research in Taiwan and, to a lesser extent, from materials gathered in similar research in Boston. The reader will find this book contains a dialectical tension between two reciprocally related orientations: it is both a cross-cultural (largely anthropological) perspective on the essential components of clinical care and a clinical perspective on anthropological studies of medicine and psychiatry. That dialectic is embodied in my own academic training and professional life, so that this book is a personal statement. I am a psychiatrist trained in anthropology. I have worked in library, field, and clinic on problems concerning medicine and psychiatry in Chinese culture. I teach cross-cultural psychiatry and medical anthropology, but I also practice and teach consultation psychiatry and take a clinical approach to my major cross-cultural teaching and research involvements. The theoretical framework elaborated in this book has been applied to all of those areas; in turn, they are used to illustrate the theory. Both the theory and its application embody the same dialectic. The purpose of this book is to advance both poles of that dialectic: to demonstrate the critical role of social science (especially anthropology and cross-cultural studies) in clinical medicine and psychiatry and to encourage study of clinical problems by anthropologists and other investigators involved in cross-cultural research.
 

Contents

The Problem the Setting and
1
Figures
3
Culture Health Care Systems
24
Types of Reality
28
Clinical Reality
42
Internal Structure
50
Core Clinical Functions
71
Popular EMS Semantic Networks and Health Care Seeking
108
Model of Cultural Impact on Affects and Affective Disorders
173
FamilyBased Popular Health Care
179
Patterns of Health Seeking Behavior
188
Diagram of Health Seeking Behavior of Three Taiwanese Patients
190
Transactions Between Explanatory
203
PractitionerPatient and FamilyPatient
259
The Healing Process
311
Implications
375

Dynamics of Interactions between Explanatory Models in PractitionerPatient Relationships
112
The Cultural Construction of Illness Experience
119
Affects and Affective Disorders
146
Glossary
389
Index
415
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About the author (1980)

Arthur Michael Kleinman, M.D. is Professor of Medical Anthropology in the Department of Social Medicine at Harvard University.

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