HSR&D Center for the Study of Helathcare Innovation, Implementation & Policy (CSHIIP) & Mental Illness Research Education & Clinical Center (MIRECC) Health Services Unit, Greater Los Angeles VA Health System, 11301 Wilshire Blvd, Los Angeles, CA, 90073, USA.
Center for Social Medicine and Humanities, Jane and Terry Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, UCLA, Los Angeles, CA, 90095, USA.
Cult Med Psychiatry. 2023 Dec;47(4):1090-1112. doi: 10.1007/s11013-023-09824-6. Epub 2023 May 3.
This clinical case study presents the case of a Latina Veteran experiencing psychosis and draws on eclectic theoretical sources, including user/survivor scholarship, phenomenology, meaning-oriented cultural psychiatry & critical medical anthropology, and Frantz Fanon's insight on 'sociogeny,' to emphasize the importance of attending to the meaning within psychosis and to ground that meaning in a person's subjective-lived experience and social world. The process of exploring the meaning and critical significance of the narratives of people experiencing psychosis is important for developing empathy and connection, the fundamental prerequisite for developing trust and therapeutic rapport. It also helps us to recognize some of the relevant aspects of a person's lived experiences. To be understood, this Veteran's narratives must be contextualized in her past and ongoing life experience of racism, social hierarchy, and violence. Engaging in this way with her narratives pushes us towards a social etiology that conceptualizes psychosis as a complex response to life experience, and in her case, a critical embodiment of intersectional oppression.
本临床案例研究介绍了一位经历精神病的拉丁裔退伍军人的案例,并借鉴了折衷的理论来源,包括用户/幸存者研究、现象学、以意义为导向的文化精神病学和批判医学人类学,以及弗朗茨·法农关于“社会发生”的见解,强调了关注精神病内在意义的重要性,并将这种意义根植于个人的主观生活体验和社会世界中。探索经历精神病的人的叙事的意义和关键意义对于培养同理心和联系至关重要,而同理心和联系是建立信任和治疗融洽关系的基本前提。它还有助于我们认识到一个人生活经历的一些相关方面。为了被理解,这位退伍军人的叙述必须在她过去和持续的种族主义、社会等级和暴力生活经历中进行背景化。以这种方式参与她的叙述,促使我们走向一种社会病因学,将精神病概念化为对生活经历的复杂反应,在她的案例中,是交叉压迫的关键体现。