Revisioning Psychiatry explores new theories and models from cultural psychiatry and psychology, philosophy, neuroscience, and anthropology that clarify how mental health problems emerge in specific contexts and points toward future integration of these perspectives. Taken together, the contributions point to the need for fundamental shifts in psychiatric theory and practice: • Restoring phenomenology to its rightful place in research and practice; • Advancing the social and cultural neuroscience of brain-person-environment systems over time and across social contexts; • Understanding how self-awareness, interpersonal interactions, and larger social processes give rise to vicious circles that constitute mental health problems; • Locating efforts to help and heal within the local and global social, economic, and political contexts that influence how we frame problems and imagine solutions. In advancing ecosystemic models of mental disorders, contributors challenge reductionistic models and culture-bound perspectives and highlight possibilities for a more transdisciplinary, integrated approach to research, mental health policy, and clinical practice.
• Interdisciplinarity - presents psychobiological, clinical, cultural, philosophical, and global mental health perspectives, allowing readers to sample cutting edge research being conducted within and outside their own disciplines
• Multi-level analysis - the book focuses on mental illness in different social and cultural contexts and at many different levels, including genetic and epigenetic, neurobiological, behavioral, clinical, cultural, political, historical, and social dimensions
• International in scope - chapters discuss fieldwork in Fiji, Indonesia, Kosovo, Liberia, Nepal, and North America
"Re-Visioning Psychiatry is a fresh attempt to examine the philosophical, cultural, and neuroscience underpinnings of psychiatry to ensure that it will be fit for purpose in the twenty-first century. The editors deserve our thanks for bringing together an impressive array of ideas to ensure that in the turmoil of debates on biology versus social determinants of health, patients do not get forgotten and receive the best treatments taking into account their individual needs."
Dinesh Bhugra CBE, Emeritus Professor of Mental Health and Diversity, Institute of Psychiatry, King's College London, and President, World Psychiatric Association
"The world has waited far too long for this visionary book and its diamond-like chapters from world experts, together showing the natural links between psychiatric phenomenology, genetics, neuroscience, culture, environment, and the mind sciences. The powerful blend of perspectives reveals a more wholesome, humanistic, and scientifically elegant understanding of brain and mind. For far too long scientific endeavours have been enslaved by disciplinary part-objects, whether anatomical, physiological, or chemical. The editors and authors should be very proud to have contributed to a new integrated science of psychiatry, at the heart of medicine, at the heart of society and fully cognizant of the social, political, and economic contexts."
Kamaldeep Bhui, President, World Association of Cultural Psychiatry, and Professor of Cultural Psychiatry and Epidemiology, Queen Mary, University of London
'As its title suggests, this is an ambitious volume, its thesis that mental disorders cannot be understood, let alone responded to, by any one discipline alone. Suffering and disability of these kinds emerge as the result of multiple factors, including the interlinked and equally important biological and personal, social and cultural.' Jennifer Radden, Metapsychology Online Reviews (www.metapsychology.mentalhelp.net)
Table of Contents
1. Introduction Laurence J. Kirmayer, Robert Lemelson and Constance A. Cummings
Part I. Restoring Phenomenology to Psychiatry:
2. Toward a new epistemology of psychiatry German E. Berrios and Ivana S. Marková
3. Phenomenology and the interpretation of psychopathological experience Josef Parnas and Shaun Gallagher
4. How the self is altered in psychiatric disorders: a neurophenomenal approach Georg Northoff
5. Cultural phenomenology and psychiatric illness Thomas J. Csordas
6. Empathy and alterity in psychiatry Laurence J. Kirmayer
7. Reflections: the community life of objects - beyond the academic clinic Nev Jones
Part II. Biosocial Mechanisms in Mental Health and Illness:
8. Dimensional and categorical approaches to mental illness: let biology decide Robert M. Bilder
9. Early-life adversity and epigenetic changes: implications for understanding suicide Benoit Labonté, Adel Farah and Gustavo Turecki
10. Understanding the neural circuitry of emotion regulation: white matter tract abnormalities and psychiatric disorder Cecile D. Ladouceur, Amelia Versace and Mary L. Phillips
11. Paying attention to a field in crisis: psychiatry, neuroscience, and functional systems of the brain Amir Raz and Ethan Macdonald
12. Reflections: hearing voices - how social context shapes psychiatric symptoms Tanya M. Luhrmann
Part III. Cultural Contexts of Psychopathology:
13. Understanding the social etiology of psychosis Kwame McKenzie and Jai Shah
14. Toward a cultural neuroscience of anxiety disorders: the multiplex model Devon E. Hinton and Naomi M. Simon
15. From the brain disease model to ecologies of addiction Eugene Raikhel
16. Cultural clinical psychology: from cultural scripts to contextualized treatments Andrew G. Ryder and Yulia E. Chentsova-Dutton
17. Psychiatric classification beyond the DSM: an interdisciplinary approach Roberto Lewis-Fernández and Neil Krishan Aggarwal
18. Reflections: the virtues of cultural sameness - the case of delusion Ian Gold
Part IV. Psychiatric Practice in Global Context:
19. Afflictions: psychopathology and recovery in cultural context Robert Lemelson and Annie Tucker
20. Eating pathology in Fiji: phenomenologic diversity, visibility, and vulnerability Anne E. Becker and Jennifer J. Thomas
21. Solving global mental health as a delivery problem: toward a critical epistemology of the solution Kalman Applbaum
22. Global mental health praxis: perspectives from cultural psychiatry on research and intervention Brandon A. Kohrt and James L. Griffith
23. Reflections: social inequalities and mental health outcomes - toward a new architecture for global mental health Duncan Pedersen
24. Conclusion: re-visioning psychiatry - toward an ecology of mind in health and illness Laurence J. Kirmayer.
About the Editors:
Laurence J. Kirmayer MD FRCPC is James McGill Professor and Director, Division of Social and Transcultural Psychiatry, Department of Psychiatry at McGill University, Montréal. He is Editor-in-Chief of Transcultural Psychiatry and Director of the Culture and Mental Health Research Unit at the Institute of Community and Family Psychiatry, Jewish General Hospital, Montréal, where he conducts research on mental health services for immigrants and refugees, indigenous peoples (First Nations, Inuit and Métis), global mental health, and the anthropology of psychiatry. He founded and directs the annual Summer Program and Advanced Study Institute in Cultural Psychiatry at McGill University. He also founded and directs the Network for Aboriginal Mental Health Research. He is a Fellow of the Canadian Academy for Health Sciences. He has received a CIHR senior investigator award, a presidential commendation for dedication in advancing cultural psychiatry from the Canadian Psychiatric Association, and both the Creative Scholarship and Lifetime Achievement Awards from the Society for the Study of Psychiatry and Culture.
Robert Lemelson is an anthropologist who received his MA from the University of Chicago and his PhD from the Department of Anthropology at the University of California, Los Angeles (UCLA). His area of specialty is Southeast-Asian studies, psychological and visual anthropology, and transcultural psychiatry. He is currently an associate adjunct professor of anthropology and a research anthropologist at the Semel Institute of Neuroscience, both at UCLA. He is also the president and founder of the Foundation for Psychocultural Research, a nonprofit research foundation supporting research and training in the neurosciences and social sciences. He has been conducting psychological and visual anthropological research in Indonesia, on the islands of Bali and Java, yearly for the past twenty years. In 2007 he founded Elemental Productions, an ethnographic documentary film production company. He has produced and directed over a dozen ethnographic films on subjects ranging from genocide, the sex trade, mental illness, kinship, ritual and further related topics.
Constance A. Cummings PhD is Project Director of the Foundation for Psychocultural Research. She is co-editor of Formative Experiences: The Interaction of Caregiving, Culture, Developmental Psychobiology (Cambridge, 2010).
Laurence J. Kirmayer, Robert Lemelson, Constance A. Cummings, German E. Berrios, Ivana S. Marková, Josef Parnas, Shaun Gallagher, Georg Northoff, Thomas J. Csordas, Nev Jones, Robert M. Bilder, Benoit Labonté, Adel Farah, Gustavo Turecki, Cecile D. Ladouceur, Amelia Versace, Mary L. Phillips, Amir Raz, Ethan Macdonald, Tanya M. Luhrmann, Kwame McKenzie, Jai Shah, Devon E. Hinton, Naomi M. Simon, Eugene Raikhel, Andrew G. Ryder, Yulia E. Chentsova-Dutton, Roberto Lewis-Fernández, Neil Krishan Aggarwal, Ian Gold, Annie Tucker, Anne E. Becker, Jennifer J. Thomas, Kalman Applbaum, Brandon A. Kohrt, James L. Griffith, Duncan Pedersen