Division of Social and Transcultural Psychiatry, McGill University, Montreal, Quebec, Canada.
Lady Davis Institute for Medical Research, Montreal, Quebec, Canada.
Cult Med Psychiatry. 2024 Dec;48(4):875-899. doi: 10.1007/s11013-024-09883-3. Epub 2024 Oct 7.
Through a longstanding collaboration, psychiatrists and anthropologists have assessed the impact of sociocultural context on mental health and elaborated the concept of culture in psychiatry. However, recent developments in ecological anthropology may have untapped potential for cultural psychiatry. This paper aims to uncover how "ecologies" inform patients' and clinicians' experiences, as well as their intersubjective relationships. Drawing on my ethnography with Jerome, a carriage driver who became my patient in a shelter-based psychiatric clinic, and on anthropological work about how psychic life is shaped ecologically, I describe how more-than-human relationality and the affordances of various places-a clinic and a stable-influenced both Jerome's well-being and my perceptions as a clinician. I also explore how these ecologies shaped our different roles, including my dual roles as psychiatrist and ethnographer. In the discussion, I define ecological factors, describe their implications for clinical practice, and suggest how they could be integrated into DSM's cultural formulation.
通过长期合作，精神科医生和人类学家评估了社会文化背景对心理健康的影响，并阐述了精神病学中的文化概念。然而，生态人类学的最新发展可能为文化精神病学提供了尚未开发的潜力。本文旨在揭示“生态”如何影响患者和临床医生的体验，以及他们的主体间关系。本文以我对杰罗姆（一位马车夫）的民族志研究为基础，他在一个避难所式的精神病诊所成为了我的患者，同时借鉴了关于心理生活如何在生态上形成的人类学工作，描述了超人类的关系和各种场所（诊所和马厩）的可能性如何影响杰罗姆的健康以及我作为临床医生的看法。我还探讨了这些生态如何塑造我们的不同角色，包括我作为精神科医生和人类学家的双重角色。在讨论中，我定义了生态因素，描述了它们对临床实践的影响，并提出了如何将它们纳入 DSM 的文化表述。
