Abstract
Efforts to provide culturally appropriate global mental health interventions have included attention to local idioms of distress. This article critically examines the potential gap between lay ethnopsychological understandings of the Cambodian idiom of baksbat (broken courage) on the one hand and clinical conceptualizations of the idiom as a potential indicator of posttraumatic stress disorder. Ethnographic semi-structured interviews with trauma survivors reveal resistance to current clinical translations and hybrid Euro-Western and Khmer treatment interventions. While the notion of idioms of distress is intended to draw attention to everyday non-pathologizing forms of discourse, the creation of hybrid assessment and treatment constructs linking idioms to trauma-related pathology may obscure the pragmatic communicative functions of the idiom, making them subordinate to an existing model of psychiatric disorder and pathologizing everyday modes of coping. Participants’ narratives highlight self-perceived connections between stressors that determine the trajectory and outcome of distress and shared cultural worldviews that together uniquely shape their meaning. These observations point to the dilemmas of linking idioms of distress with co-morbid illness constructs in ways that may pathologize normal emotional responses. Results have implications for efforts to develop effective models of post-conflict trauma care in global mental health.
Original language | English |
---|---|
Pages (from-to) | 211-235 |
Number of pages | 25 |
Journal | Culture, Medicine and Psychiatry |
Volume | 43 |
Issue number | 2 |
DOIs | |
State | Published - 15 Jun 2019 |
Bibliographical note
Publisher Copyright:© 2018, Springer Science+Business Media, LLC, part of Springer Nature.
Keywords
- Cambodia
- Cultural competence
- Global mental health
- Idioms of distress
- Khmer
- Trauma
ASJC Scopus subject areas
- Health(social science)
- Anthropology
- Arts and Humanities (miscellaneous)
- Psychiatry and Mental health