Abstract
I thoroughly enjoyed this book. It covers a vast array of fascinating worlds from the study of first-rank symptoms in Iban people of Sarawak, Malaysia, to a refreshing and provocative new look at negative symptoms in schizophrenia.
The introduction, preface and the list of contents leads the reader to expect a well-researched and scholarly collection of essays.
The book is organized in three parts: an up-to-date understanding of culture, self and experience; ethnographic, sociolinguistic, clinical and historical aspects of schizophrenia; and a section that provides a deep and poignant elaboration on subjectivity and emotion.
The ability to see something from another person's point of view is fundamental to being human and nowhere is this more important than in psychiatry. This book is unique in the study of schizophrenia. It examines the subtle but rich interface between the presentation of psychosis and the person's background. The psychotic experience as shaped by culture, society, family, community, language, and particular interactions and processes in the inner world and how this affects the course of schizophrenia is well explained. The book has breadth and depth and information that is immediately relevant to, and enhances clinical practice.
I found each chapter informative, exceptionally interesting and thought-provoking. The chapter on the innovative and carefully developed program for the homeless mentally ill in Bogota, Columbia has unique and insightful case-studies with tantalizing titles such as ‘From marauding Viking to Security Guard’, ‘The Potion’, and ‘I Love Begging.’ The studies include vibrant excerpts quoted directly from the patient.
The superficial understanding of culture as purely ‘otherness’, ‘difference’ and dichotomous, does little to further an understanding of individuals and their particular contexts. The contributing authors in this volume put together a ‘primer’ which ably answers the questions: ‘What large-scale cultural influences could be at play?’ and ‘How do these influences affect this person in this setting?’
This book is powerful in its capacity to provide an understanding of the lived experience of schizophrenia. It describes the complexities of subjective experiences of the illness that create suffering in the patients, their families and caregivers. It certainly achieves one of the stated goals of the editors, which is to provide mental health professionals with approaches that help them understand their patients better. This book is particularly valuable for the practical clinical implications of the research presented.
The section on Subjectivity and Emotion is illuminating, beautifully written and describes the very disparate narratives of first-person accounts of the experience of schizophrenia from the ‘professional’ third person (those who diagnose, treat and study them) narratives. The whole issue of authority and authenticity is explored in detail and puts in perspective the pain and anger that often comes through in pathographies and consumer representations. It highlights the difficulties (and ineptitude) of treating clinicians and organizations in providing humane recognition of the suffering from an illness like schizophrenia, and healing rather than treatment.
This is a book you can read for pleasure at bed-time, but it is also a serious and scholarly work. It is highly recommended to psychiatrists and all mental health professionals alike. It is a ‘must read’ to enrich and enhance the current overly medicalized encounter between clinicians and patients.