Nepali Concepts of Psychological Trauma: The Role of Idioms of Distress,Ethnopsychology and Ethnophysiology in Alleviating Suffering and Preventing Stigma |
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Authors: | Brandon A Kohrt Daniel J Hruschka |
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Institution: | (1) Department of Anthropology, Emory University, 1557 Dickey Dr., Atlanta, GA 30322, USA;(2) Department of Psychiatry, Emory University School of Medicine, 2004 Ridgewood Dr., Atlanta, GA 30322, USA;(3) Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal;(4) School of Human Evolution and Social Change, Arizona State University, SHESC 233, P.O. Box 872402, Tempe, AZ 85287-2402, USA |
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Abstract: | In the aftermath of a decade-long Maoist civil war in Nepal and the recent relocation of thousands of Bhutanese refugees from
Nepal to Western countries, there has been rapid growth of mental health and psychosocial support programs, including posttraumatic
stress disorder treatment, for Nepalis and ethnic Nepali Bhutanese. This medical anthropology study describes the process
of identifying Nepali idioms of distress and local ethnopsychology and ethnophysiology models that promote effective communication
about psychological trauma in a manner that minimizes stigma for service users. Psychological trauma is shown to be a multifaceted
concept that has no single linguistic corollary in the Nepali study population. Respondents articulated different categories
of psychological trauma idioms in relation to impact on the heart-mind, brain-mind, body, spirit, and social status, with
differences in perceived types of traumatic events, symptom sets, emotion clusters and vulnerability. Trauma survivors felt
blamed for experiencing negative events, which were seen as karma transmitting past life sins or family member sins into personal loss. Some families were reluctant to seek care for psychological
trauma because of the stigma of revealing this bad karma. In addition, idioms related to brain-mind dysfunction contributed to stigma, while heart-mind distress was a socially acceptable
reason for seeking treatment. Different categories of trauma idioms support the need for multidisciplinary treatment with
multiple points of service entry. |
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Keywords: | |
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