Traces of culture: The feedback loop between behavior, brain, and disorder.

Culture is part of an extensive series of feedback loops, which involve multiple organismic levels including social contexts, cognitive mediations, neural processes, and behavior. Recent studies in neuroscience show that culturally contingent social processes shape some neural pathways. Studying the influence of cultural context on neural processes may yield new insights into psychiatric disorders. New methodologies in the neurosciences offer innovative ways to assess the impact of culture on mental health and illness. However, implementing these methodologies raises important theoretical and ethical concerns, which must be resolved to address patient individuality and the complexity of cultural diversity. This article discusses cultural context as a major influence on (and consequence of) human neural plasticity and advocates a culture-brain-behavior (CBB) interaction model for conceptualizing the relationship between culture, brain, and psychiatric disorders. Recommendations are made for integrating neuroscientific techniques into transcultural psychiatric research by taking a systems approach to evaluating disorders.

La psicología como técnica de subjetivación / Psychology as a technique of subjectification

Se propone de forma tentativa una concepción de la Psicología que pretende desplazar las cuestiones epistemológicas (qué clase de ciencia es, de serlo) y las teóricas y metodológicas (cuál debe ser su objeto y su método) adoptando una perspectiva basada en la genealogía de cuño foucaultiano y en la antropología de la ciencia de autores como Bruno Latour. Para ello, se marca distancia con la llamada Psicología crítica y se argumenta que la Psicología importa más por lo que hace que por lo que dice (aunque decir es también hacer) y que funciona ante todo como una práctica de subjetivación. Se termina revisando brevemente algunos trabajos que intentan mostrar ese funcionamiento en casos concretos

A conception of psychology is tentatively proposed which aims to displace epistemological questions (what kind of science it is, if it is a science) and theoretical and methodological questions (what its object and its method should be). Instead, a perspective is adopted that is based on Foucauldian genealogy and the anthropology of science by authors such as Bruno Latour. An attempt is made to create distance with respect to so-called critical psychology. It is argued that psychology matters more for what it does than for what it says (although saying is also doing) and that it functions mainly as a practice of subjectivation. This paper ends by briefly reviewing a number of works that attempt to show this functioning in specific cases

El tercer espacio: propiedades de desplazamiento de la experiencia psicocultural / The Third Space: Displacement Properties of the Psycho-Cultural Experience

Resumen El propósito de este artículo consiste en presentar el tema El tercer espacio: propiedades de desplazamiento de la experiencia psicocultural. Se refiere al espacio potencial del desarrollo temprano humano,que hace contrapunto en su devenir histórico con el mundo sociocultural. Surge mayormente de la reflexión concienzuda obtenida de la clínica psicoanalítica con consultantes niños y adultos, así como de la investigación sobre la relación entre psicoanálisis y literatura. La psicoterapia con niños sucede en un espacio de juego, en un taller de trabajo psicológico donde se explicitan los síntomas perturbadores y se vehiculiza el conflicto, en una zona intermedia, así llamada por D.W. Winnicott, no tan lejana del tratamiento con consultantes adultos donde al transcurrir el proceso de análisis del inconsciente se produce un tiempo-espacio de ambigüedad y extrañamiento. Tales procesos de naturaleza clínica permiten observar que en el devenir y la producción cultural humana se hace notar un espacio que se abre hasta que se define el traslado experiencial. Ese es el tercer espacio. Otro modo de observar ese tercer espacio se encuentra en el lenguaje; ese componente ambiguo, incierto, se efectúa mediante el desplazamiento semántico en el texto literario. Así, ese tiempo-espacio de ambigüedad, propicio para el desplazamiento de procesos de lenguaje, convertido en hechos culturales como obra artística o fenómeno psicosocial, tiene como basamento procesos transicionales intrapsíquicos advertidos desde el desarrollo precoz. De manera amplia, el tercer espacio se propone como ámbito teórico e investigativo dado que constituye un aporte a la lectura y a la investigación textual psicoanalítica.

Abstract: The purpose of this article is to present the topic: The Third Space: Displacement Properties of the Psycho-Cultural Experience, referring to the potential space in early human development, which interacts with its historic occurrence in the socio-cultural world. It arises mostly from thoughtful consideration obtained from psychoanalytic consultation with children and adults, as well as investigation of the relationship between psychoanalysis and literatura Psychotherapy with children takes place in a play space, in a psychological workshop where the symptoms causing a disturbance are identified and the conflict is focused in an intermediate zone, thus named by D.W. Winnicott; it is not that far from the treatment of adult patients, wherein the analysis process of the subconscious takes place and creates a time and space of ambiguity and estrangement. Such processes of a clinical nature allow observing that throughout these and human cultural production there is a space which is opened until the transfer of the experience takes place, that is the: third space. Another way to observe this third space is through language; the ambiguous and uncertain component, which takes place in semantic displacement in the literary text. Therefore that temporal and spatial ambiguity, which encourages the displacement of language processes, into cultural expression and artistic productions or psychosocial phenomena, has as its foundation those intra-psychic transitional processes, noticed since early development. Taken amply, the third space is proposed as a theoretical and investigative field becauseit contributes to the reading and investigation of psychoanalytic texts

Cultural concealment and therapy outcomes.

Therapy is predicated on the need for clients to share intimate details about their lives, including their cultural values, attitudes, and beliefs. Previous studies have found that clients conceal certain aspects of their lives including, but not limited to their symptoms and their feelings about the therapy process. To date, there has not been an investigation focused on whether clients conceal aspects of their cultural identities, whether some therapists are more likely to have clients conceal aspects of their cultural identities, and if cultural concealment is associated with therapy outcomes. The present study attempted to do so utilizing the caseloads of 37 therapists who treated a total of 233 clients in a university counseling center setting. Client data were collected at the end of treatment utilizing the Patient's Estimate of Improvement (PEI; Hatcher & Barends, 1996), a measure that assesses client change on domains including general functioning, symptom related distress, intimate and social relationships, work or school, feelings about oneself, behavior, control of life, and tolerance for and ability to share painful feelings. Cultural concealment was assessed via 5 items regarding the amount and circumstances under which clients withheld cultural identity based information in therapy. Results indicated that within therapists' caseloads, client's ratings of cultural concealment were negatively associated with therapy outcomes. Additionally, therapists whose clients rated more cultural concealment on average had clients with worse therapy outcomes. Lastly, there was a significant contextual effect indicating that within and between therapist cultural concealment were statistically different from one another. (PsycINFO Database Record

¿Qué haría usted ante un paciente musulmán con trastorno conversivo? / What would you do when faced with a Muslim patient with a conversational disorder?

El propósito de este trabajo es reflexionar sobre el abordaje de los desórdenes mentales en pacientes marroquíes desde una perspectiva sociocultural. La antropología de la salud y la etnopsiquiatría permitirán analizar los conceptos de salud y enfermedad. Desde la cosmovisión marroquí analizaremos los tratamientos alternativos a la psiquiatría y su articulación con otros modelos terapéuticos (AU)

The purpose of this work is to present the approach to mental disorders in Moroccan patients from a sociocultural perspective. The anthropology of health and ethno-psychiatry will allow us to analyze the concepts of health and disease. From the Moroccan cosmovision we will analyze the alternative treatments and their association with other therapeutic models (AU)

Know Your Monkey: Identifying Primate Conservation Challenges in an Indigenous Kichwa Community Using an Ethnoprimatological Approach.

Increasing pressure on tropical forests is continually highlighting the need to find new solutions that mitigate the impact of human populations on biodiversity. However, developing solutions that can tackle the drivers of anthropogenic pressure, or at least take them into account, hinges upon building a good understanding of the culture and perceptions of local people. This study aims to provide an overview of the ethnoprimatology of an indigenous Kichwa community in the Ecuadorian Amazon that maintains a traditional lifestyle but also has good access to markets. We examine whether primates are seen as a distinctive group and their relative importance as sources of bushmeat and as household pets. Pile-sorting exercises revealed that although locals generally group members of the order Primates together, tree-dwelling non-primates including sloths, coatis, kinkajous and tamanduas are also frequently classified as 'monkeys'. The perceived importance of primates to the forest and the community lay more in their potential as bushmeat, and only 1 respondent identified an ecological role for the group in terms of seed dispersal. Gaining a better understanding of local perceptions will allow for better-informed conservation decisions that are more aware of potential impacts and are more likely to gain community support.

Reconciling evidence-based practice and cultural competence in mental health services: introduction to a special issue.

The calls for evidence-based practice (EBP) and cultural competence (CC) represent two increasingly influential mandates within the mental health professions. Advocates of EBP seek to standardize clinical practice by ensuring that only treatment techniques that have demonstrated therapeutic outcomes under scientifically controlled conditions would be adopted and promoted in mental health services. Advocates of CC seek to diversify clinical practice by ensuring that treatment approaches are designed and refined for a multicultural clientele that reflects a wide variety of psychological orientations and life experiences. As these two powerful mandates collide, the fundamental challenge becomes how to accommodate substantive cultural divergences in psychosocial experience using narrowly prescriptive clinical practices and approaches, without trivializing either professional knowledge or cultural difference. In this Introduction to a special issue of Transcultural Psychiatry, the virtue of an interdisciplinary conversation between and among anthropologists, psychologists, psychiatrists, and social work researchers in addressing these tensions is extolled.

At the crossroads of anthropology and epidemiology: current research in cultural psychiatry in the UK.

Cultural psychiatry research in the UK comprises a broad range of diverse methodologies, academic disciplines, and subject areas. Methodologies range from epidemiological to anthropological/ethnographic to health services research; mixed methods research is becoming increasingly popular, as are public health and health promotional topics. After briefly outlining the history of cultural psychiatry in the UK we will discuss contemporary research. Prominent themes include: the epidemiology of schizophrenia among Africans/Afro-Caribbeans, migration and mental health, racism and mental health, cultural identity, pathways to care, explanatory models of mental illness, cultural competence, and the subjective experiences of healthcare provision among specific ethnic groups such as Bangladeshis and Pakistanis. Another strand of research that is attracting increasing academic attention focuses upon the relationship between religion, spirituality, and mental health, in particular, the phenomenology of religious experience and its mental health ramifications, as well as recent work examining the complex links between theology and psychiatry. The paper ends by appraising the contributions of British cultural psychiatrists to the discipline of cultural psychiatry and suggesting promising areas for future research.

Cultural psychiatry: a general perspective.

The current scene in the field of cultural psychiatry shows a vigorous growth, multifaceted conceptual and research developments and more relevant clinical presence. After a pertinent definition of the discipline, this chapter examines the contribution of cultural psychiatry to the etiopathogenesis of mental disorders, to the variations of clinical presentations in numerous entities, to psychiatric diagnosis and treatment and to the relatively unexplored rubric of preventive psychiatry. Advanced concepts of neurosciences and technology-based research can find a place in the realm of biocultural correlates. The role of culture in the definition of mental illness, the renewed notions of the old 'culture-bound syndromes', hope, cognition and culture in psychiatric treatments (including the so-called 'cultural therapies'), and resiliency are areas duly examined and discussed. Cultural psychiatry has re-emerged as a reliable body of knowledge aimed at a comprehensive assessment of human beings as patients.

Trends in cultural psychiatry in the United kingdom.

Cultural psychiatry in the United Kingdom exhibits unique characteristics closely related to its history as a colonial power, its relationship with Commonwealth countries and the changing socio-demographic characteristics of its diverse population throughout the centuries. It is not surprising, therefore, that the emergence of this discipline was centred around issues of race and religion. After a brief historical review of the development of cultural psychiatry and the mention of pioneering intellectual and academic figures, as well as the evolvement of the field in organizations such as the Royal College of Psychiatrists, this chapter examines the need of a critical cultural psychiatry, more than a narrative social science distanced from the realities of clinical practice. In such context, issues such as policies and experience with efforts to delivering race equality, and address inequities in a renewed public health approach seem to confer British cultural psychiatry with a defined socially active role aimed at the pragmatic management, understanding and improvement of diverse and alternative systems of care and care practices.

Cultural psychiatry in the French-speaking world.

For the last five centuries, France's international influence has been constant. This has been particularly evident in the areas of general culture, history and science. In psychiatry, the role of Pinel during the French Revolution, and the discovery of the first psychotropic agent, chlorpromazine, by Delay and Deniker are two outstanding historical facts. This chapter examines the contributions of French social scientists in the understanding of the sequelae of colonial exploitation, racism and political oppression. The establishment of a multi-ethnic society in France and Francophile regions of the world has led to the gradual creation of a cultural psychiatry rich in terminological influences, clinical understanding, training programs and research. Closer connections between French psychiatric thought and Anglophile psychiatry is likely to produce beneficial effects.

Ethnopsychopharmacology and pharmacogenomics.

Significant differences in response to psychotropic drugs are observed in various ethnic and cultural groups. Ethnopsychiatry is the study of how culture and genetic differences in human groups determine and influence the response to psychotropic agents. Meanwhile, pharmacogenomics studies the influence of genetic variations in the response of patients to different drugs. Pharmacogenetic tests are used to predict drug response and the potential for adverse effects. There are important genetic variations that influence the metabolism and action of psychotropic drugs in different ethnic groups. As examples, the frequencies of CYP2D6 polymorphisms and of the long and short alleles of the promoter region of the serotonin transporter are analyzed. Studies found significant differences in the frequency of polymorphisms of both genes in different countries and ethnic groups. On the basis of this review, the importance of considering ethnic and cultural factors in the prescription of drugs and in the need of further pharmacogenetic studies in different countries and geographical regions is reaffirmed.

Cultural psychiatry: research strategies and future directions.

This chapter reviews some key aspects of current research in cultural psychiatry and explores future prospects. The first section discusses the multiple meanings of culture in the contemporary world and their relevance for understanding mental health and illness. The next section considers methodological strategies for unpacking the concept of culture and studying the impact of cultural variables, processes and contexts. Multiple methods are needed to address the many different components or dimensions of cultural identity and experience that constitute local worlds, ways of life or systems of knowledge. Quantitative and observational methods of clinical epidemiology and experimental science as well as qualitative ethnographic methods are needed to capture crucial aspects of culture as systems of meaning and practice. Emerging issues in cultural psychiatric research include: cultural variations in illness experience and expression; the situated nature of cognition and emotion; cultural configurations of self and personhood; concepts of mental disorder and mental health literacy; and the prospect of ecosocial models of health and culturally based interventions. The conclusion considers the implications of the emerging perspectives from cultural neuroscience for psychiatric theory and practice.

A cultural neuroscience approach to the biosocial nature of the human brain.

Cultural neuroscience (CN) is an interdisciplinary field that investigates the relationship between culture (e.g., value and belief systems and practices shared by groups) and human brain functions. In this review we describe the origin, aims, and methods of CN as well as its conceptual framework and major findings. We also clarify several misunderstandings of CN research. Finally, we discuss the implications of CN findings for understanding human brain function in sociocultural contexts and novel questions that future CN research should address. By doing so, we hope to provide a clear picture of the CN approach to the human brain and culture and to elucidate the intrinsically biosocial nature of the functional organization of the human brain.