This paper examines some of the difficulties of exporting the Western concept of Post Traumatic Stress Disorder (PTSD) to non-Western cultures. Using data drawn from Guatemala 1 where I lived and worked among Quiché Mayan war widows, illustrates how cultural ly-specif ic understandings of events and reactions to them affect the well-being (or otherwise) of people exposed to extreme adverse events. The paper turns2 to the voices of the widows, who experienced and survived intense political conflict, explaining their experiences of violence within their particular context.
Get full access to this article
View all access options for this article.
References
1.
AmericanPSYCHIATRIC ASSOCIATION (APA). (1980) Diagnostic and Statistical Manual III (DSM-III). Washington D.C.: American Psychiatric Association.
2.
Ardener, S. (1986) Visibility and Power. Essays on Women in Society and Development. Delhi: Oxford University Press.
3.
Bracken, P.J., Giller, J.E. & Kabaganda, S. (1992) Helping Victims of Violence in Uganda. Medicine and War, 8, 155.
4.
Bracken, P.J., Giller, J.E. & Summerfield. D. (1995) Psychological Responses to War and Atrocity: The Limitations of Current Concepts. Social Science and Medicine, 40: 8, 1073-1082.
5.
Brody, E.B. (1990) The new biological determinism in socio-cultural context. Australian and New Zealand Journal of Psychiatry , 24, 464-469.
6.
Burgess, A.W. & Holmstrom, L.L. (1974) Rape trauma syndrome. American Journal of Psychiatry,131, 981.
7.
Chakraborty, A. (1991) Culture, colonialism and psychiatry. Lancet, 337, 1204-1207.
8.
Corin, E. (1993) Les Détours de la raison. Reperes Sémiologiques pour une anthropologie de la folie. Anthropologie et Sociétés , 17, 1-2, 5-20.
9.
Eisenbruch, M. (1991) From posttraumatic stress disorder to cultural bereavement: Diagnosis of South-east Asian refugees. Social Science and Medicine, 33:6, 673-680.
10.
Eisenbruch, M. (1992) Towards a cuturatly sensitive DSM: Cultural bereavement in Cambodian refugees and the traditional healer as taxonomist. Journal of Nervous and Mental Disease, 180: 1, 8-10.
11.
Farmer, P.A. (1980) New approach to psychiatric diagnosis: acultural or anglicized? FirstContact, 6, 11- 14.
12.
Gaines, A.D. (1992a) From DSM-1 to III-R; voices of self, mastery and the other: A cultural constructivist reading of U.S. psychiatric classification , Social Science and Medicine, 35: 1, 3-24.
13.
Gaines, A.D. (ed.) (1992b) Ethnopsychiatry: The Cultural Construction of Folk and Professional Psychiatries. New York: Albany Press.
14.
Gaines, A.D. & Hahan, R.A. (1985) Among the physicians: Encounter, Exchange and Transformation . In Physicians of Western Medicine: Anthropological Approaches to Theory and Practice (eds.) Hahan, R.A. & Gaines, A.D.Dordrecht: D. Reidel.
15.
Geertz, C. (1986) "From the native's point of view" On the nature of anthropological understanding. In: Shwcdcr, R. and R.A. LeVine. Culture Theory: Essays on Mind, Self and Emotion. Cambridge: Cambridge University Press.
16.
Gillin, J. (1948) "Magical Fright". In Human Ways: selected essays in anthropology. [1969]Pittsburgh: Pittsburgh University Press.
17.
Herman, J.L. (1992) Trauma and Recovery. New York : Basic Books.
18.
Horowitz, M.J. (1986) Stress Response Syndromes, 2nd ed. New York: Jason Aronson.
19.
Kleber, R.J. & Brom, D. (1992) Coping with Trauma. Theory, Prevention and Treatment . Swets and Seitlinger.
20.
Kleinman, A. (1977) Depression, somatization and the new 'cross-cultural' psychiatry'. Social Science and Medicine. Berkeley: University of California Press.
21.
Kleinman, A. (1987a) Anthropology and psychiatry. The role of culture in cross-cultural research on illness. British Journal of Psychiatry, 151, 447.
22.
Kleinman, A. (1987b) Culture and clinical reality: commentary on culture bound syndromes and international disease classifications. Culture, Medicine and Phychiatry, 11, 49.
23.
Lifton, R.J. (1986) The Nazi Doctors: Medical Killing and the Psychology of Genocide. New York: Basic Books .
24.
Lipowski, L. (1988) Somatization: The concept and its clinical application . American Journal of Psychiatry,145, 1358-1368.
25.
Morris, B. (1994) Anthropology of the Self: the individual in perspective . London: Pluto Press.
26.
Ramsay, R. & Stansfield, S.A. (1988) After the Horror. British Medical Journal, 296, 1603.
27.
Ramsay, R. ET AL (1993) Psychiatric morbidity in survivors of organized state violence including torture. A restrospective series. British Journal of Psychiatry, 162, 55-59,
28.
Rubel, A. (1964) The epidemiology of a folk illness: susto in Hispanic America. Ethnology, 3: 2, 268-283.
29.
Summerfield, D. (1996) The Impact of War and Atrocity on Civilian Populations: Major themes for NGO interventions and a Critique of Psychosocial Trauma Projects , Relief and Rehabilitation Network O.D.I.: May.
30.
Swartz, L.P. & Levett, A. (1990) Political oppression and children in South Africa: the social construction of damaging effects. In Political violence and the struggle in South Africa (eds.) Manganyi, N.C. & du Toit, A.London: McMillan.
31.
Thygesen. P. (1980) The concentration camp syndrome. Danish Medical Bulletin, 27, 224.
32.
Ursano, R.J. (1992) Posttraumatic stress disorder and meaning: Structuring human chaos. Journal of Nervous and Mental Disorders, 180: 12, 756-759.
33.
Wilson, M. & Maccarthy, B. (1994) GP consultation as a factor in the low rate of mental health service use by Asians. Psychological Medicine , 24, 113-119.
34.
Yehuda, R. & Mcfarlane, A.C. (1995) Conflict between current knowledge about posttraumatic stress disorder and its original conceptual basis. American Journal of Psychiatry,152: 12, 1705-1713.
35.
Young, A. (1990) Moral conflicts in a psychiatric hospital treating combat-related posttraumatic stress disorder (PTSD). In Social Science Perspectives on Medical Ethics, (ed.) Weisz, G.Dordrecht: Kluwer Academic Press.
36.
Young, A. (1991) Emil Kraepelin and the origins of American psychiatric diagnosis. In Athropologies Medicine (eds.) Pfleiderer, B. & Bibeau, G.Wiesbaden: Vieweg.
37.
Zur, Judith (1993) "Violent Memories: Quiché War Widows in Northwest Highland Guatemala". Ph.D dissertation. University of London .
