Rashed, M.A.;
(2012)
Subjectivity, society and the experts: discourses of madness in the western desert of Egypt.
Doctoral thesis , UCL (University College London).
Abstract
Medical anthropological and cross-cultural studies utilise a positivist conceptualisation of schizophrenia: a disorder outside of, yet influenced by, culture. Two ideas challenge this notion: first, 'schizophrenia' is one meaning-giving framework among many, including spirit-possession, which subsume a range of phenomena. Second, illness cannot be grounded in matters of fact but in the personal experience of distress. Through field-work in Egypt's Dakhla Oasis and subsequent philosophical analysis, this study develops the relation between meaning and illness by examining the impact of local understandings of psychotic phenomena on the experience of distress. In Dakhla, psychotic phenomena are the effects of spirits or problems 'in the head'. Local conceptualisations of spirits render them vulnerable to acts of faith allowing positive individual responses to distressing experiences that are not seen with physical formulations where illness is irreversible and suffering endured passively. Thus there is a relation between the meanings generated in a particular case and the subjective experience of distress. The theoretical basis of this relation is explored through two approaches. (1) With narrative, subjects incorporate distressing experiences into coherent, continuous threads of meaning which restore predictability and control. (2) Semiosis concerns the immediate responses to psychotic states, which may be more or less distressing relative to the semiotic object. Semiotic analysis reveals that attributing psychotic states to external agents, rather than sub-personal brain processes, is not 'delusional' but expected. The relation between distress and meaning suggests that the utility of various representations - spirit-possession or schizophrenia — should not be judged against a purported 'true' explanation of the phenomena, but by subjects' abilities to actively respond to their experiences such that distress is alleviated. This relation supports a clinical approach to psychosis where meaning is taken as a primary resource to be utilised in the management of distress: the Hermeneutic Clinic.
| Type: | Thesis (Doctoral) |
|---|---|
| Title: | Subjectivity, society and the experts: discourses of madness in the western desert of Egypt |
| Language: | English |
| Additional information: | Permission for digitisation not received |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1344078 |
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