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康复后仍面临的污名化:精神病康复后的生活策略

Stigma despite recovery: strategies for living in the aftermath of psychosis.

作者信息

Jenkins Janis H, Carpenter-Song Elizabeth A

机构信息

Department of Anthropology, University of California-San Diego, USA.

出版信息

Med Anthropol Q. 2008 Dec;22(4):381-409. doi: 10.1111/j.1548-1387.2008.00038.x.

Abstract

In this article, we identify an array of creative strategies used by persons diagnosed with schizophrenia-related illness to deflect and resist social stigma, and address the lived experience of deploying these strategies in the intersubjective context of everyday life. The data are derived from anthropological interviews and ethnographic observations of ninety persons who received treatment at community mental health facilities in an urban North American locale. Nearly all were keenly aware of stigma that permeated their lives. Their predicament is contradictory: on the one hand, they have recovered relative to previous states of psychosis; on the other hand, their subjectivity is saturated by intense awareness of social stigma that seems intractable in relation to temporal or functional criteria. Ironically, these lives can be characterized as fraught with stigma despite recovery. The strategies generated to resist the impact of stigma highlight the fact that persons with these illnesses are often not only exceedingly socially aware but also strategically skilled in response to social assaults on their personhood and survival. We examine these strategies in terms of (1) the social characteristics of each afflicted person, (2) the situational characteristics of managing stigma, (3) the cultural context of recovery, and (4) the illness-specific characteristics of schizophrenia.

摘要

在本文中,我们识别出一系列被诊断患有精神分裂症相关疾病的人所采用的创造性策略,这些策略用于转移和抵抗社会污名,并探讨在日常生活的主体间情境中运用这些策略的实际体验。数据来源于对北美一个城市社区心理健康机构接受治疗的90人的人类学访谈和人种志观察。几乎所有人都敏锐地意识到弥漫在他们生活中的污名。他们的困境是矛盾的:一方面,相较于之前的精神病状态,他们已经康复;另一方面,他们的主体性被对社会污名的强烈意识所充斥,而这种污名在时间或功能标准方面似乎难以消除。具有讽刺意味的是,尽管已经康复,但这些人的生活仍充满污名。为抵抗污名影响而产生的策略凸显了这样一个事实,即患有这些疾病的人往往不仅具有极强的社会意识,而且在应对针对其人格和生存的社会攻击时具备策略技巧。我们从以下几个方面审视这些策略:(1)每个患者的社会特征,(2)管理污名的情境特征,(3)康复的文化背景,以及(4)精神分裂症的疾病特异性特征。

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