Institute of Social and Cultural Anthropology, Göttingen University, Theaterplatz 15, 37073, Göttingen, Germany.
Cult Med Psychiatry. 2017 Dec;41(4):564-589. doi: 10.1007/s11013-017-9541-z.
Based on ethnographic fieldwork, this article looks at changing discourses and practices in the field of mental health care in Uganda. In particular, it analyzes two psychotherapeutic institutions designed to treat drug- and alcohol-addiction, and their accessibility and affordability for people from different class backgrounds. The first center is a high-class residential facility near Kampala which offers state-of-the-art addiction therapy, but is affordable only for the rich. The second center, a church-funded organization in Northern Uganda, cares mainly for people from poor, rural families who cannot afford exp/tensive treatment. Comparing the two centers provides important insights not only into the temporalities of mental illness, substance abuse and mental health care, but also into broader socio-economic dynamics and understandings of suffering in contemporary Uganda. The term 'class-based chronicities' refers to the way both the urgency with which people seek treatment (when has someone suffered enough?) and the length of treatment they receive (when is someone considered 'recovered'?) are highly class-dependent. On a theoretical level, the article shows how psychotherapeutic models operate as philosophical systems which not only impact on treatment practices, but also produce different addiction entities and addiction-related subjectivities. As such, it contributes to an emerging anthropology of addiction.
本文基于民族志实地调查，探讨了乌干达心理健康护理领域中不断变化的话语和实践。特别是，本文分析了两个旨在治疗药物和酒精成瘾的心理治疗机构，以及它们对不同社会阶层背景的人的可及性和负担能力。第一个中心是坎帕拉附近的一个高档住宅式设施，提供最先进的成瘾治疗，但只有富人才能负担得起。第二个中心是乌干达北部一个教会资助的组织，主要照顾来自贫困农村家庭的人，他们无法负担昂贵的治疗费用。比较这两个中心不仅提供了对精神疾病、药物滥用和精神保健的时间性以及更广泛的社会经济动态和对当代乌干达苦难的理解的重要见解，而且还提供了对精神疾病、药物滥用和精神保健的时间性以及更广泛的社会经济动态和对当代乌干达苦难的理解的重要见解。“基于阶级的慢性”一词是指人们寻求治疗的紧迫性（当某人遭受的痛苦足够多时？）和他们接受治疗的时间长度（当某人被认为“康复”时？）高度依赖于阶级。从理论上讲，本文展示了心理治疗模式如何作为哲学体系运作，不仅影响治疗实践，而且还产生不同的成瘾实体和与成瘾相关的主体性。因此，它为正在出现的成瘾人类学做出了贡献。
