Idioms of distress: Alternatives in the expression of psychosocial distress: A case study from South India

This paper focuses attention on alternative modes of expressing distress and the need to analyze particular manifestations of distress in relation to personal and cultural meaning complexes as well as the availability and social implications of coexisting idioms of expression. To illustrate this point the case of South Kanarese Havik Brahmin women is presented. These women are described as having a weak social support network and limited opportunities to ventilate feelings and seek counsel outside the household. Alternative means of expressing psychosocial distress resorted to by Havik women are discussed in relation to associated Brahminic values, norms and stereotypes. Somatization is focused upon as an important idiom through which distress is communicated. Idioms of distress more peripheral to the personal or cultural behavioral repertoire of Havik women are considered as adaptive responses in circumstances where other modes of expression fail to communicate distress adequately or provide appropriate coping strategies. The importance of an ‘idioms of distress’ approach to psychiatric evaluation is noted.

[1]  Mark A. Nichter Health ideologies and medical cultures in the South Kanara areca-nut belt , 1977 .

[2]  Arthur Kleinman,et al.  The theoretical foundations of Chinese medicine : systems of correspondence , 1975, The Journal of Asian Studies.

[3]  I. Zwerling Approaches to the Mind , 1975 .

[4]  M. N. Srinivas Caste in modern India, and other essays , 1963 .

[5]  R. Lauer,et al.  The Great Universe of Kota: Stress, Change and Mental Disorder in an Indian Village. , 1977 .

[6]  H. Hartmann Essays On Ego Psychology , 1964 .

[7]  B. Good,et al.  The Meaning of Symptoms: A Cultural Hermeneutic Model for Clinical Practice , 1981 .

[8]  M. Foucault,et al.  The birth of the clinic : an archaeology of medical perception , 1974 .

[9]  M. Douglas Purity and Danger , 1966 .

[10]  J. Sussex,et al.  Cultural Values and Ego Functioning in Relation To the Atypical Culture-Bound Reactive Syndromes , 1971 .

[11]  P. Claus Spirit possession and spirit mediumship from the perspective of Tulu oral traditions , 1979, Culture, medicine and psychiatry.

[12]  H. Hartmann Ego psychology and the problem of adaptation , 1958 .

[13]  D. Mechanic THE INFLUENCE OF MOTHERS ON THEIR CHILDREN'S HEALTH ATTITUDES AND BEHAVIOR. , 1964, Pediatrics.

[14]  M. Nichter Part Two: Patterns of resort in the use of therapy systems and their significance for health planning in South Asia , 1978 .

[15]  J. Kluger Childhood asthma and the social milieu. , 1969, Journal of the American Academy of Child Psychiatry.

[16]  I. Lewis,et al.  Ecstatic Religion: An Anthropological Study of Spirit Possession and Shamanism , 1971 .

[17]  Lalit C. Bhandari THE IMPACT OF AYURVEDIC IDEAS ON THE CULTURE AND THE INDIVIDUAL IN CEYLON by GANANATH OBEYESEKERE. Mimeograph. 54 pp. To be published in Charles Leslie (ed.), Towards a Comparative Study of Asian Medical Systems , 1972 .

[18]  A. Kleinman,et al.  Patients and Healers in the Context of Culture: An Exploration of the Borderland between Anthropology, Medicine, and Psychiatry. , 1983 .

[19]  Americal Psychiatric Press Diagnostic and Statistical Manual of Mental Disorders, Third Edition , 1980 .

[20]  I. K. Zola Culture and symptoms--an analysis of patients' presenting complaints. , 1966, American sociological review.

[21]  G. M. Carstairs,et al.  Hinjra and jiryan: two derivatives of Hindu attitudes to sexuality. , 1956, The British journal of medical psychology.

[22]  E. K. Gough Cults of the Dead among the Nayars , 1958 .

[23]  M. Nichter Negotiation of the illness experience: Ayurvedic therapy and the psychosocial dimension of illness , 1981, Culture, medicine and psychiatry.

[24]  Edward B. Harper Fear and the Status of Women , 1969, Southwestern Journal of Anthropology.