Discourses of Culture and Illness in South African Mental Health Care and Indigenous Healing, Part I: Western Psychiatric Power

Abstract

This discourse analytic study explores constructions of culture and illness in the talk of psychiatrists, psychologists and indigenous healers as they discuss possibilities for collaboration in South African mental health care. Versions of 'culture', and disputes over what constitutes 'disorder', are an important site for the negotiation of power relations between mental health practitioners and indigenous healers. The results of this study are presented in two parts. Part I explores discourses about western psychiatric/psychological professionalism, tensions in diagnosis between cultural relativism and psychiatric universalism, and how assertion of 'cultural differences' may be used to resist psychiatric power. Part II explores how discursive constructions of 'African culture' and 'African madness' work to marginalize indigenous healing in South African mental health care, despite repeated calls for collaboration.

The Influence of Socio-Cultural Beliefs in Chris Hani Baragwanath Academic Hospital (Chbah): A Social Work Perspective

“…South African society embraces both faith and traditional healing practices in addition to Western medical pluralism (Yen & Willbraham, 2003) [4]. Some of these healing modalities have been found to be effective while others have been proven to be harmful to people's health and well-being (Armernakis & Kiefer, 2007; Yen & Willbraham, 2003) [5].…”

“…Some of these healing modalities have been found to be effective while others have been proven to be harmful to people's health and well-being (Armernakis & Kiefer, 2007; Yen & Willbraham, 2003) [5].…”

Revisiting Psychotherapeutic Practices in Karnataka, India: Lessons from Indigenous Healing Methods

“…Several studies emphasize the need to understand folk healing (set of beliefs that has a shared social dimension, it is what people do when they are ill, as compared with what they should do as determined by a set of social standards (Wing, 1998). The discourse analytic study by Yen & Wilbraham (2003) looked at conversations among psychiatrists, psychologists and indigenous healers, with regard to culture and illness, as they discussed possibilities for collaboration in South African mental health care. It explored discourses about western psychiatric/ psychological professionalism, tensions in diagnosis between cultural relativism and psychiatric universalism, and how assertion of 'cultural differences' may be used to resist psychiatric power.…”

A critical review of practices of inclusion and exclusion in the psychology curriculum in higher education

“…In this respect, studies have foregrounded structural inequalities, lack of demographic representativeness and the role of psychology in transformation and "undoing" apartheid legacies (for example, Ahmed & Pillay, 2004;De la Rey & Ipser, 2004;Pretorius, 2008;Sher & Long, 2012). There has also been increased grappling with issues of cultural, religious and epistemological relevance -particularly efforts at Africanising psychology -gaining momentum in South Africa (for example, Holdstock, 2000;Yen & Wilbraham, 2003a, 2003bMkhize, 2004aMkhize, , 2004bEskell-Blokland, 2005;Patel & Shikongo, 2006;Diale & Fritz, 2007;Baloyi, 2008;Ngcobo & Edwards, 2008;Eskell-Blokland, 2009;Ruane, 2010;Bojuwoye & Edwards, 2011;Eagle & Long, 2011;Edwards, 2011;Makunga, Thwala & Edwards, 2011;Sodi & Bojuwoye, 2011;Ebersöhn, 2012;Matoane, 2012;Theron, Theron & Malindi, 2013;Laher, 2014;Padayachee & Laher, 2014) and other African countries (for example, Mpofu, 2002;Bandawe, 2005;Nwoye, 2011;Javangwe, 2013).…”

“…In this respect, studies have foregrounded structural inequalities, lack of demographic representativeness and the role of psychology in transformation and "undoing" apartheid legacies (for example, Ahmed & Pillay, 2004; De la Rey & Ipser, 2004;Pretorius, 2008;Sher & Long, 2012). There has also been increased grappling with issues of cultural, religious and epistemological relevance -particularly efforts at Africanising psychology -gaining momentum in South Africa (for example, Holdstock, 2000;Yen & Wilbraham, 2003a, 2003bMkhize, 2004aMkhize, , 2004bEskell-Blokland, 2005;Patel & Shikongo, 2006; Diale & Fritz, 2007; Baloyi, 2008;Ngcobo & Edwards, 2008;Eskell-Blokland, 2009;Ruane, 2010; Bojuwoye & Edwards, 2011; Eagle & Long, 2011;Edwards, 2011;Makunga, Thwala & Edwards, 2011;Sodi & Bojuwoye, 2011;Ebersöhn, 2012;Matoane, 2012;Theron, Theron & Malindi, 2013 Recommendations around transforming the curriculum have included the following: taking African cultures, languages, healing processes and experiences as the point of departure for the psychology curriculum (Baloyi 2008); establishing departments where postgraduate students research African worldviews in order to create a foundation for an African indigenous psychology (Juma 2011); and introducing dedicated courses in African psychology (Nwoye, 2011;Matoane, 2012;Javangwe, 2013) and dedicated modules on cultural issues (Eagle, 2005;Matoane, 2012). Critical psychologists and others have also cautioned against reproducing essentialised and ahistorical notions of culture and ethnicity in this pursuit (Rashed, 2013) and perpetuating misperceptions that equate culture with black and poor people, but not white and middleclass people (Yen & Wilbraham, 2003b).…”