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康复诠释学:促进非洲与西方心理健康框架之间的对话。

The hermeneutics of recovery: Facilitating dialogue between African and Western mental health frameworks.

作者信息

Kong Camillia, Campbell Megan, Kpobi Lily, Swartz Leslie, Atuire Caesar

机构信息

Birkbeck College, London, United Kingdom.

Rhodes University, Grahamstown, South Africa.

出版信息

Transcult Psychiatry. 2023 Jun;60(3):428-442. doi: 10.1177/13634615211000549. Epub 2021 Mar 24.

Abstract

The widespread use of faith-based and traditional healing for mental disorders within African contexts is well known. However, normative responses tend to fall within two camps: on one hand, those oriented towards the biomedical model of psychiatry stress the abuses and superstition of such healing, whilst critics adopting a more 'local' perspective have fundamentally challenged the universalist claims of biomedical diagnostic categories and psychiatric treatments. What seemingly emerges is a dichotomy between those who endorse more 'universalist' or 'relativist' approaches as an analytical lens to the challenges of the diverse healing strands within African contexts. In this article, we draw upon the resources of philosophy and existing empirical work to challenge the notion that constructive dialogue cannot be had between seemingly incommensurable healing practices in global mental health. First, we suggest the need for much-needed conceptual clarity to explore the hermeneutics of meaning, practice, and understanding, in order to forge constructive normative pathways of dialogue between seemingly incommensurable values and conceptual schemas around mental disorder and healing. Second, we contextualise the complex motives to emphasise difference amongst health practitioners within a competitive healing economy. Finally, we appeal to the notion of recovery as discovery as a fruitful conceptual framework which incorporates dialogue, comparative evaluation, and cross-cultural enrichment across divergent conceptualisations of mental health.

摘要

在非洲背景下,基于信仰和传统的精神疾病治疗方法被广泛使用,这是众所周知的。然而,规范性的回应往往分为两个阵营:一方面,那些倾向于生物医学精神病学模式的人强调这种治疗方法的滥用和迷信,而采取更“本土化”视角的批评者则从根本上挑战了生物医学诊断类别和精神病治疗方法的普遍主义主张。似乎出现的是,在那些支持更“普遍主义”或“相对主义”方法的人之间存在二分法,他们将这些方法作为分析非洲背景下多样治疗方法所面临挑战的视角。在本文中,我们利用哲学资源和现有的实证研究成果,来挑战那种认为在全球心理健康领域看似不可通约的治疗实践之间无法进行建设性对话的观点。首先,我们提出需要进行急需的概念澄清,以探索意义、实践和理解的诠释学,从而在围绕精神障碍和治疗的看似不可通约的价值观和概念模式之间建立建设性的规范性对话途径。其次,我们将健康从业者在竞争性治疗经济中强调差异的复杂动机置于具体情境中进行考量。最后,我们呼吁将康复视为发现的理念,作为一个富有成效的概念框架,它包含了跨不同心理健康概念化的对话、比较评估和跨文化丰富。

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