Pragmatic truths about illness experience: Idioms of distress around Alzheimer’s disease in Oaxaca, Mexico

Abstract

This article explores the pragmatic sensibilities that are implicit in idioms of distress among family caregivers for Alzheimer’s disease in Teotitlán del Valle, a rural Zapotec-speaking community in Oaxaca, Mexico. Through analysis of caregivers’ perceptions of progressive memory loss and related etiological understandings, this article emphasizes the pragmatism inherent to local health perspectives. In so doing, the article revisits Nichter’s earliest formulation of idioms of distress as providing an alternative epistemological framework to appreciate how illness is varyingly understood. Such a framework is useful for understanding how idioms of distress are not aimed towards attaining accuracy about what illness is in an objective sense, but rather put into focus how such descriptions are both constitutive of—and themselves pragmatic responses to—broader social circumstances. This article concludes with a consideration of how idioms of distress empower individuals as agents of action.

Una reflexión sobre las actitudes hacia la Enfermedad de Alzheimer

“…Los resultados obtenidos suscitaron preguntas acerca de la importancia que pueden tener las actitudes en la práctica profesional de quienes trabajan con pacientes que la sufren. En consonancia con los componentes de las actitudes antes mencionados, la literatura revisada muestra la existencia de algunas creencias sobre la etiología de la EA en cuanto a factores ajenos al control de la persona 21 , otros relacionados con el comportamiento [22][23][24][25][26] , enfermedades o alteraciones fisiológicas [27][28][29][30][31] (tabla 1), curso y características de esta entidad.…”

“…La EA es causada por: -voluntad de Dios (21) -destino (22) -genética(23) -envejecimiento (24) -sustos(25) -experiencias de alto impacto emocional (traumáticas) (25) La EA es causada por: -estilos de vida no saludables -baja actividad cognitiva(26) -el aislamiento social( 22) -pensar mucho (25) La EA es causada por: -eventos cerebrovasculares o mini-ictus(27) -enfermedad cerebral(28) -fallas químicas en el cerebro(29) -efectos de medicamentos recibidos antes de la aparición de la EA(30) -estrés (25,31) La EA es causada por: -tristeza(25) -bajos niveles educativos (26) Tabla 1. Creencias sobre etiología de la EA En relación con la creencia de que el envejecimiento es un factor etiológico de la EA, un estudio realizado en 2020 por Algahtani y col. mostró que más de 60% de sus participantes aducían que la EA afecta a los adultos mayores.…”

Actualized inventory of medicinal plants used in traditional medicine in Oaxaca, Mexico

“…These complex traditional medical systems analyze the etiologies, symptoms, and developments of diseases themselves (e.g., [40,41]). They also address the treatments that must be followed, which include the use of medicinal plants and series of cultural practices, such as pedimento ceremonies to the mountains (traditional practices such as praying and offering alcoholic beverages), in which healers follow other rituals to guarantee healing [12,13,24].…”

Toward a methodology of chance: On obstacles to research and their advantages.

“…Through illustration of the obstacles posed in accessing data for research on Alzheimer’s disease caregiving in Oaxaca, Mexico (Yahalom, 2016, 2019a), this article demonstrates how methodological agility allows for the development of a research approach to collect data that is constituted in and reflexively aware of the complex, nuanced experience of participants’ everyday lives. This contrasts with standard rationalist views of research that posit that data can be acquired about people’s experience that is objective and preformulated, something that would surface irrespective of context (Belzile & Öberg, 2012).…”

“…Simply put, individuals come to express themselves differently—and have different experiences—depending on the environment they find themselves in. People change what they say and experience based on power imbalances (Anyan, 2013; Elwood & Martin, 2000; Jakobsen, 2012; Wilkinson, 1998b), social stigma (Goffman, 2009/1974; Yahalom, 2019b, Yahalom, 2020), social norms (Narayan, 2013), and more. As this article will describe, obstacles experienced while conducting research represent an additional dimension to the social context that qualitative researchers must study.…”