Nichter M
Cult Med Psychiatry. 1981 Dec;5(4):379-408. doi: 10.1007/BF00054782.
This paper focuses attention on alternative modes of expressing distress and the need to analyze particular manifestations of distress in relation to personal and cultural meaning complexes as well as the availability and social implications of coexisting idioms of expression. To illustrate this point the case of South Kanarese Havik Brahmin women is presented. These women are described as having a weak social support network and limited opportunities to ventilate feelings and seek counsel outside the household. Alternative means of expressing psychosocial distress resorted to by Havik women are discussed in relation to associated Brahminic values, norms and stereotypes. Somatization is focused upon as an important idiom through which distress is communicated. Idioms of distress more peripheral to the personal or cultural behavioral repertoire of Havik women are considered as adaptive responses in circumstances where other modes of expression fail to communicate distress adequately or provide appropriate coping strategies. The importance of an 'idioms of distress' approach to psychiatric evaluation is noted.
本文着重关注表达痛苦的替代方式，以及分析痛苦的特定表现形式与个人和文化意义复合体之间的关系，同时关注共存的表达方式的可用性和社会影响。为说明这一点，本文呈现了南卡纳拉塞哈维克婆罗门妇女的案例。这些妇女被描述为社会支持网络薄弱，在家庭之外宣泄情感和寻求建议的机会有限。文中讨论了哈维克妇女用来表达心理社会痛苦的替代方式，并将其与相关的婆罗门价值观、规范和刻板印象联系起来。躯体化被视为一种重要的表达痛苦的方式。对于哈维克妇女个人或文化行为模式中较为次要的痛苦表达方式，本文认为在其他表达方式无法充分传达痛苦或提供适当应对策略的情况下，这些方式是适应性反应。文中还指出了“痛苦表达方式”方法在精神病学评估中的重要性。
