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中国对西方精神病学的引进:文化相对性与精神障碍

China's importation of Western psychiatry: cultural relatively and mental disorders.

作者信息

Woo D

机构信息

Community Studies Board, University of California, Santa Cruz 95064.

出版信息

Theor Med. 1991 Mar;12(1):25-43. doi: 10.1007/BF02134776.

DOI:10.1007/BF02134776
PMID:1853296
Abstract

As one aspect of China's modernization, the importation of Western psychiatric ideas poses a mystery. How are such ideas integrated with traditional assumptions? The apparently wholesale adoption of Western psychiatric categories runs counter to the fact that the Chinese have been generally reluctant to define problems in highly individualized psychiatric terms. Our lack of knowledge as to how the Chinese and Western medical models interface raises questions about the cross-cultural applicability of psychiatric theory. Ironically, the very conceptual categories intended to facilitate professional discourse obscure cultural, political, and epistemological differences between Chinese and Western thought. This paper focuses on certain incongruities in psychiatric theory and practice in order to underscore many unresolved issues that still exist with respect to our cross-cultural understandings of 'mental illness'. Insofar as the trend has been towards standardizing methodology, taxonomies have been generated without a corresponding development in textured comparison. Originating from Western theoretical frameworks, comparative analyses have been otherwise devoid of culture-specific knowledge. The goal of this paper is to show that these categorical assumptions are still premature, and that examining the meaning of current 'rates of mental illness' in China specifically raises more questions than it answers. Hopefully, this discussion will stimulate a renewed interest in ethnographic methods that would uncover locally-based understandings and thereby create the basis for a more sophisticated epidemiological comparison.

摘要

作为中国现代化进程的一个方面,西方精神病学思想的引入是个谜。这些思想如何与传统观念相结合?表面上对西方精神病学分类的全盘采用,与中国人通常不愿用高度个体化的精神病学术语来界定问题这一事实相悖。我们对中西医模式如何衔接缺乏了解,这引发了关于精神病学理论跨文化适用性的问题。具有讽刺意味的是,那些旨在促进专业话语交流的概念分类,却掩盖了中西思想在文化、政治和认识论上的差异。本文聚焦于精神病学理论与实践中的某些不一致之处,以强调在我们对“精神疾病”的跨文化理解方面仍然存在许多未解决的问题。就目前的趋势是使方法标准化而言,分类法已经产生,但在深入细致的比较方面却没有相应的发展。比较分析源于西方理论框架,除此之外缺乏特定文化知识。本文的目的是表明这些分类假设仍为时过早,具体审视中国当前“精神疾病发病率”的意义所引发的问题比所回答的问题更多。希望这场讨论能激发人们对人种志方法重新产生兴趣,这种方法将揭示基于当地的理解,从而为更复杂的流行病学比较创造基础。

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