Toward a Puerto Rican Popular Nosology: Nervios and Ataque de Nervios

This paper is about naming illnesses—about who determines what categories are used and the implications of these determinations. The central concerns of medical/psychiatric anthropology have been to understand popular categories of and systems for classification of illness, to examine the relationship of illness categories to cultural understandings of the body, and to interpret the role of categories of illness in mediating between the personal and social spheres. At the same time, the paper also discusses the interplay of popular categories and psychiatric diagnoses. This paper examines the multiple experiences of nervios among Puerto Ricans in Puerto Rico and New York City. Our contention is that nervios is more than a diffuse idiom of distress, and that there are different categories and experiences of nervios which provide insights into how distress is experienced and expressed by Puerto Ricans and point to different social sources of suffering. The data in this paper come from the responses to a series of open-ended questions which tapped into people's general conceptions of nervios and ataques de nervios. These questions were incorporated into follow-up interviews to an epidemiological study of the mental health of adults in Puerto Rico. The results suggest ways to incorporate these different categories of nervios into future research and clinical work with different Latino groups in the United States and in their home countries.     

Whose Tangle is it Anyway? The African‐American Family,Poverty and United States Kinship

The comparison between United States immigrant and African‐American families presented by Daniel Patrick Moynihan in his 1965 report to President Lyndon Johnson remains the most popular folk model for explaining success, failure and mutual aid in poverty. Despite being savaged by social science in its first two decades and largely ignored in the last two, the Moynihan model is an enduring part of popular discourses on race, intensified by contemporary immigrant success narratives. Based on over three years of participant observation research among homeless African‐American and Latino men and their families and Latin‐American immigrants engaging in small business creation in New York City, I argue that Moynihan's empirically valid claim that certain immigrant family forms are more suited to mutual aid in crisis is misused to present the African‐American family as dysfunctional when its kinship norms are actually typically American.     

“Traveling Pains”: Embodied Metaphors of Suffering Among Southern Sudanese Refugees in Cairo

This paper presents the results of a larger study conducted among Southern Sudanese refugees in Cairo, Egypt. "Illness talk" and body metaphors are the focus of the present work, which is based mainly on an analysis of the illness narratives of people attending a church-run medical clinic. The findings suggest that refugees use certain narrative styles in discussing their illnesses that highlight the interconnection of bodily ills and refugee-related trauma. The refugees narrated the histories of their illnesses in terms consistent and coterminous with their refugee histories, and articulated illness causes in terms of threatening assaults on their sense of self as human beings and as part of a distinct community and culture. The use of embodied metaphors to understand and cope with their current and past traumatic experiences was echoed in narratives that were nonillness related. Metaphors such as "the heart," "blood," and "body constriction" were consistently used to discuss social and cultural losses. Understanding the role that the body plays in experience and communication within a given cultural context is crucial for physicians and others assisting refugees.     

Naming and grouping illnesses in Feira (Brazil)

This paper examines the naming and grouping of illnesses in the popular medicine of Feira de Santana, a city in Northeastern Brazil, in a context of medical pluralism. It discusses the principles used to name illnesses in Feira and the semantic shifts evident in popular nomenclature; examines the grouping of illnesses in Feira; and shows the flexibility of these situationally negotiated categorizations. It also analyzes the place of symptoms in local nosological knowledge and examines three folk illnesses as an illustration of the discussion of illness classification.     

<Emphasis Type="Italic">Susto</Emphasis> and<Emphasis Type="Italic"> Nervios</Emphasis>: Expressions for Stress and Depression

Folk illnesses that are cultural constructions of psychological distress offer a vehicle for the cross-cultural study of stress and stress-related morbidity. This study explores the relationship between the Latin American folk illnesses susto and nervios and mental health. We hypothesize that these folk illnesses are distinct and that there is a stronger association between current levels of stress and depressive symptoms with past experience of nervios than with susto, because the cultural constructions of these folk illnesses reflect chronic and acute concepts of distress, respectively. Interviews were conducted in Guadalajara, Mexico, where participants responded to questions about their socio-demographic characteristics, stress, depressive symptoms, and whether they had experienced susto or nervios. Susto and nervios are very prevalent and occur across sociodemographic subgroups, with the exception that nervios occurred more often in women (p < 0.05). Susto was significantly associated with stress and depressive symptoms (p < 0.05), but nervios had a much stronger association (p < 0.0001), even after controlling for gender. Susto and nervios were expressions of psychological distress; most of those with depression reported susto and/or nervios. This study validates the link between these folk illnesses and stress and depression and may, ultimately, facilitate cross-cultural research on stress.     

Caida de Mollera among Children of Mexican Migrant Workers: Implications for the Study of Folk Illnesses

Information about the folk illness caida de mollera was collected from Mexican and Mexican American migrant mothers who had treated their children for the illness, and from physicians in a clinic that served this population. These physicians believed that the vast majority of the sets of symptoms were worthy of medical attention and could be life threatening if not treated. This research report concurs with other studies that suggest that although Mexican folk illnesses are conceptualized to have folk-social and psychological causes, they are also seen to have biological causes and physiological symptoms that can be treated by biomedical methods. This report outlines a model for understanding aspects of folk illnesses that includes folk vs. biomedical ideas about disease, causes vs. symptoms, and psychological vs. physiological aspects of sickness. It also suggests that the kinds of questions anthropologists ask about these illnesses may need to be modified—shifting away from questions about treatments of causes and refocusing on those about the treatment of physiological symptoms—if we are to more fully understand home approaches to the management of these illnesses, [folk illnesses, Mexican, Mexican American, farmworkers]     

Health,Welfare Reform,and Narratives of Uncertainty Among Cambodian Refugees

Massive disruptions to a way of life, such as thosebrought on by widespread violence, terror, andgenocide, disorder the body as well as the socialorder. When they flee their homelands, refugees bringtheir experiences of violence and terror with them. Drawing on an ethnographic study of 40 Cambodianrefugees between the ages of 50 and 79 who sufferedfrom one or more chronic illnesses, we explore howrefugees who live with chronic illnesses and aredependent on government support were affected by thethreat of welfare reform. When welfare reformthreatened to cut Cambodian refugees' income, it poseda new crisis for those who were chronically in limboand placed further constraints on their lives. Through their narratives, Cambodian refugees enactedtheir bodily distress and resisted the threat ofwelfare reform. The story of threatened welfarereform in the U.S. and its possible consequences forrefugees is a story of quixotic U.S. politics,policies and antidotes for refugeeism gone awry.     

The racial body is gendered: a comment on Emirbayer and Desmond’s The Racial Order

ABSTRACT

In The Racial Order, Emirbayer and Desmond offer a systematic theory of race. The social psychology of race is central to the theoretical framework of this book. In their discussion of bodily aesthetics, bodily cognition, and bodily morality, they neglect the important theoretical insights and empirical contributions of feminist sociologists who have studied the racialized and gendered body. The exclusion of the intersectional research of feminist sociologists weakens their analysis of ‘relational social epistemology’. Intersectional research conducted by feminist sociologists during the past decade should be central to any theoretical discussion of the social psychology of race in North America, which is their primary focus.     

Painful languages of the body: experiences of headache among women in two peruvian communities

This exploratory study focuses on the understandings of and experiences with headache in two settings in Peru: the Quechua-speaking district of Ayacucho, in southern Peru, and a poor urban district of Lima Metropolitana. More specifically, it explores the personal and collective meanings constructed around women’s headache experiences. Structured and open-ended interviews were administered to patients suffering headache to elicit interpretations of headache episodes. An analysis of the collected narratives suggests that headache is often comprehended in a polysemic framework, where meanings ascribed in bodily, emotional, family, and social terms articulate individual and shared notions of suffering within larger contexts of social dislocation. Often woven into experiences of solitude, headache accounts are lived and told in dynamic temporal spaces, and narrate dissolution of family ties and tensions associated with women’s roles. The results underscore the significance of patients’ subjective interpretations of painful experiences and underscore the connections between bodily and emotional pain and distress experienced at family, community, and larger social levels.     

Illness behavior and dysfunction: review of concepts and application to chronic pain

The purpose of this presentation is to review the elements that comprise the concept of illness behavior including elaboration of a more formal theoretical and operational model for illness behavior and then discuss the application of the illness behavior model to chronic pain, especially chronic orofacial pain. The model of illness behavior presented emphasizes four critical areas of conceptual interest, namely, (1) monitoring of somatic signals; (2) cognitive processes whereby bodily symptoms are interpreted; (3) attaching meaning to symptoms in the context of emotional state and concurrent environmental events; and (4) the ethnocultural influences that pervade meaning and shape coping responses. Our model of illness behavior was generalized from a closely related model developed to guide research when the specific illness behavior of interest was dysfunctional chronic pain behavior. We also include a time dimension in our chronic pain model. Dysfunctional chronic pain is understood to be the most important undesirable consequence associated with suffering a persistent pain condition. Dysfunctional chronic pain is a subset of illness behaviors inconsistent with medically documented findings, while the complaints of pain are prominent. Changes occur in emotional status, most typically reported as mood and behavioral changes associated with depression, such as demoralization, helplessness, and social isolation. Excesses in medical care, hospitalizations for surgery, and abuse of medications are further characteristics of dysfunctional chronic pain.     

Identity,Subjectivity, and Disorders of Self in Psychosis

Alterations in self-experience are increasingly attended to as relevant and important aspects of schizophrenia, and psychosis more broadly, through a burgeoning self-disorders (SD) literature. At the same time, issues of self, subject, and subjectivity within schizophrenia-spectrum illnesses have also gained attention from researchers across the social sciences and humanities, and from ethnographic research especially. This paper examines the subjective experience of disruptions in self-identity within a cohort of first episode psychosis (FEP) service users, critically engaging with the SD literature and bringing it into conversation with social sciences and humanities scholarship on self and schizophrenia. Drawing findings from an ongoing ethnographic study of young peoples’ experiences with psychosis, we explore meanings of mental distress relating to psychotic episodes and attend to issues of self, identity, and subjectivity. We critique the division between “normal” and “pathological” self-experience that is endorsed within the SD literature, arguing against the notion that fragmentation of self-experience in schizophrenia-spectrum illnesses is indicative of psychopathology. We highlight how experiences categorized as psychosis are also important and complete aspects of one’s social world and inner life and explore the ways in which at least some aspects of disruptions of self-identity stem from clinical situations themselves—in particular, from asymmetries of power within the mental health system. Relating our findings to feminist, postcolonial, and disability studies’ approaches to the “self,” we emphasize the complex interplay between interpersonal, cultural, and structural aspects of self-experience within FEP.

     

Asperger’s Syndrome,Subjectivity and the Senses

Situated at the intersection of anthropological work on illness narratives and research on the anthropology of autism, this paper is a close reading of an autobiographical narrative recounted by Peter, a young man diagnosed with Asperger’s Syndrome, a type of autism spectrum disorder (ASD). Responding to Solomon’s (2010a:252) call for phenomenologically grounded accounts of “the subjective, sensory, and perceptual experiences of autism … based on personal narratives and practices of being and self-awareness,” this paper calls into question key assumptions in the clinical and popular literature about ASD relating to theory of mind, empathy, capacity for metaphorical thinking, and ASD as a life-long condition.     

Acknowledging Individual Responsibility while Emphasizing Social Determinants in Narratives to Promote Obesity-Reducing Public Policy: A Randomized Experiment

This study tests whether policy narratives designed to increase support for obesity-reducing public policies should explicitly acknowledge individual responsibility while emphasizing social, physical, and economic (social) determinants of obesity. We use a web-based, randomized experiment with a nationally representative sample of American adults (n = 718) to test hypotheses derived from theory and research on narrative persuasion. Respondents exposed to narratives that acknowledged individual responsibility while emphasizing obesity’s social determinants were less likely to engage in counterargument and felt more empathy for the story’s main character than those exposed to a message that did not acknowledge individual responsibility. Counterarguing and affective empathy fully mediated the relationship between message condition and support for policies to reduce rates of obesity. Failure to acknowledge individual responsibility in narratives emphasizing social determinants of obesity may undermine the persuasiveness of policy narratives. Omitting information about individual responsibility, a strongly-held American value, invites the public to engage in counterargument about the narratives and reduces feelings of empathy for a character that experiences the challenges and benefits of social determinants of obesity.     

Latino/a professionals as entrepreneurs: how race,class, and gender shape entrepreneurial incorporation

ABSTRACT

This paper examines how race, class, and gender intersect to shape professional Latinos’ entrepreneurial incorporation, as observed by the conditions that prompt professional Latinos to start a business, including access to capital and experiences with discrimination. In-depth interviews with professional Latino business owners in Los Angeles reveal that individual human capital – via resources and wealth accrued through corporate careers – facilitates entrepreneurial activity. Race, ethnicity, and gender, as intersectional social group identities, combine with class to shape variegated impacts on access to capital and business experiences by gender and target market. Ethnicity is a resource for those serving the coethnic community and is more significant in shaping business ownership experiences for men who target a racially/ethnically diverse clientele, whereas gender and race are more salient for women outside the coethnic community. This study contributes to the ethnic enterprise literature by going beyond ethnicity to demonstrate that multiple dimensions of identity shape professional Latino/as’ entrepreneurial incorporation.     

Writing failure: knowledge production,temporalities, ethics,and traces

This volume follows failures out into the world, exploring how they unfold ethnographically. Taking a longer view shows how objects, narratives, and diagnoses of failures may be crafted, acted on, suffered, resisted – unmade or recomposed. Thus while tropes and diagnoses of failure can temporarily (re)organize, narrate, and stabilize the world, the kinds of failures explored here also indicate a mode of uncontainable excess that refuses the boundedness of knowledge objects, temporalities, and spaces. This volume offers three main interventions. The first concerns knowledge production: how objects of failure are crafted through selective ways of knowing that occlude both other modes of apprehension at different scales and failure's many affective valences. The second thinks through the knotted temporalities – whether pasts, futures, suspended presents, or repetition and sedimentation – that make and are made by failure. Finally, writing about unfurling failures requires careful attention to non-linear reverberations and traces as well as to open-ended and mobile narratives that produce different social and material effects.     

Affective loop experiences: designing for interactional embodiment

Involving our corporeal bodies in interaction can create strong affective experiences. Systems that both can be influenced by and influence users corporeally exhibit a use quality we name an affective loop experience. In an affective loop experience, (i) emotions are seen as processes, constructed in the interaction, starting from everyday bodily, cognitive or social experiences; (ii) the system responds in ways that pull the user into the interaction, touching upon end users'' physical experiences; and (iii) throughout the interaction the user is an active, meaning-making individual choosing how to express themselves—the interpretation responsibility does not lie with the system. We have built several systems that attempt to create affective loop experiences with more or less successful results. For example, eMoto lets users send text messages between mobile phones, but in addition to text, the messages also have colourful and animated shapes in the background chosen through emotion-gestures with a sensor-enabled stylus pen. Affective Diary is a digital diary with which users can scribble their notes, but it also allows for bodily memorabilia to be recorded from body sensors mapping to users'' movement and arousal and placed along a timeline. Users can see patterns in their bodily reactions and relate them to various events going on in their lives.The experiences of building and deploying these systems gave us insights into design requirements for addressing affective loop experiences, such as how to design for turn-taking between user and system, how to create for ‘open’ surfaces in the design that can carry users'' own meaning-making processes, how to combine modalities to create for a ‘unity’ of expression, and the importance of mirroring user experience in familiar ways that touch upon their everyday social and corporeal experiences.But a more important lesson gained from deploying the systems is how emotion processes are co-constructed and experienced inseparable from all other aspects of everyday life. Emotion processes are part of our social ways of being in the world; they dye our dreams, hopes and bodily experiences of the world. If we aim to design for affective interaction experiences, we need to place them into this larger picture.     

Desire,Envy and Punishment: A Matsigenka Emotion Schema in Illness Narratives and Folk Stories

Accumulating evidence suggests that folktales in some societies are characterized by a culturally constructed underlying emotional structure, or Cultural Emotion Schema. In this paper we argue that Matsigenka illness narratives and folk stories share an underlying emotion schema, in which death and suffering result from conflicts between strong-willed individuals prompting anger and aggression. Analysis of illness narratives collected by Izquierdo in the Matsigenka community of Kamisea in the Peruvian Amazon between 1996 and 1999 reveals a common pattern in which envy and frustration lead to the belief in sorcery as the main cause of illness and death. This pattern contrasts with the typical stories of a previous generation collected by the Johnsons among the Matsigenka of Shimaa and other Matsigenka researchers, where sorcery beliefs were virtually absent. Our argument is that important changes in ecology, community, politics, and religion have led to a systematic rise in feelings of envy and frustration, and that these have increased the likelihood that sorcery accusations will occur. We explore the likelihood that such beliefs increase as egalitarian peoples become more crowded into settlements where they are likely to experience greater inequality, more competition for resources and increased societal and personal stress.     

The baladi curative system of Cairo,Egypt

The article explores the symbolic structure of the baladi (traditional) cultural system as revealed in everyday narratives, with a focus on baladi curative action. The everyday illness narrative provides a cultural window to the principles of fluidity and restorative balance of baladi curative practices.The body is seen as a dynamic organism through which both foreign objects and physiological entities can move. The body should be in balance, as with any humorally-influenced system, and so baladi cures aim to restore normal balance and functioning of the body.The article examines in detail a narrative on treatment of a sick child, and another on treatment of fertility problems. It traces such cultural oppositions as insider : outsider; authentic: inauthentic; home remedy: cosmopolitan medicine. In the social as well as the medical arena these themes organize social/medical judgements about correct action and explanations of events.