Rubinstein Ellen B
Department of Family Medicine, University of Michigan, 1018 Fuller Road, Ann Arbor, MI, 48104, USA.
Cult Med Psychiatry. 2018 Dec;42(4):755-777. doi: 10.1007/s11013-018-9595-6.
This article presents an account of how Japanese parents in a family support group for mental illness constructed understandings of care for adult children with serious mental illness, primarily schizophrenia. I build from Janis H. Jenkins's research on the "extraordinary condition" of schizophrenia to discuss "extraordinary care," which parents practiced as a way to refute cultural and clinical beliefs about pathogenic families and degenerative diseases. Parents' accounts of extraordinary care revealed a reliance on biomedical knowledge to treat the symptoms of mental illness coupled with an ongoing determination to improve children's lives beyond what psychiatry could offer. Extraordinary care thus points to the therapeutic limits of biomedical psychiatry while also reinforcing the significance of social relations as families work toward recovery.
本文讲述了日本一个精神疾病家庭支持小组中的父母如何构建对患有严重精神疾病(主要是精神分裂症)的成年子女的照料理解。我借鉴贾尼斯·H·詹金斯关于精神分裂症“特殊状况”的研究,来探讨“特殊照料”,这是父母采取的一种方式,用以反驳关于致病家庭和退行性疾病的文化及临床观念。父母对特殊照料的描述揭示了他们依靠生物医学知识来治疗精神疾病症状,同时也展现出持续的决心,要在精神病学所能提供的范围之外改善孩子的生活。因此,特殊照料指出了生物医学精神病学的治疗局限性,同时也强化了社会关系在家庭康复过程中的重要性。