Cristea Florin, Aryani Putu, Herdiyanto Yohanes K
Institute of Social and Cultural Anthropology, Free University Berlin, Berlin, Germany.
Department of Social and Cultural Anthropology, University of Münster, Münster, Germany.
Med Anthropol Q. 2025 Jun;39(2):e12906. doi: 10.1111/maq.12906. Epub 2024 Dec 19.
In this article, we examine the clinical encounters of people diagnosed with a severe mental illness (SMI). Drawing on more than 1-year of ethnographic research and interviews in Indonesia, we show that instances of moral self-reflection occurring in the process of acquiring and appropriating clinical insight emerge at the intersection of heterogeneous discursive regimes. When biomedical notions of health and illness dominate these discourses, they reimagine pre-existing notions about spirituality and religion. Furthermore, consenting to psychiatric notions of health and illness can create common ground and a sense of shared experience, leading to grassroots movements for the empowerment of the mentally ill, self-help groups, and other support structures. At the same time, these processes can increase uncertainty and be generative of a culture of blame, as individuals are caught in overlapping and at times contradictory moral systems that each have the potential to strip patients of their moral status.
在本文中，我们考察了被诊断患有严重精神疾病（SMI）者的临床遭遇。基于在印度尼西亚进行的一年多的人种志研究和访谈，我们表明，在获取和应用临床洞察力的过程中出现的道德自我反思实例，出现在异质话语体系的交叉点上。当健康和疾病的生物医学观念主导这些话语时，它们会重新构想关于灵性和宗教的既有观念。此外，认同精神疾病的健康和疾病观念可以创造共同点和共享体验感，从而催生增强精神病患者权能的草根运动、自助团体及其他支持结构。与此同时，这些过程可能会增加不确定性，并产生一种指责文化，因为个体陷入了重叠且有时相互矛盾的道德体系中，而每个体系都有可能剥夺患者的道德地位。
