From the Preface, by Arthur Kleinman:Patients and Healers in the Context of Culture presents a theoretical framework for studying the relationship between medicine, psychiatry, and culture. That framework is principally illustrated by materials gathered in field research in Taiwan and, to a lesser extent, from materials gathered in similar research in Boston. The reader will find this book contains a dialectical tension between two reciprocally related orientations: it is both a cross-cultural (largely anthropological) perspective on the essential components of clinical care and a clinical perspective on anthropological studies of medicine and psychiatry. That dialectic is embodied in my own academic training and professional life, so that this book is a personal statement. I am a psychiatrist trained in anthropology. I have worked in library, field, and clinic on problems concerning medicine and psychiatry in Chinese culture. I teach cross-cultural psychiatry and medical anthropology, but I also practice and teach consultation psychiatry and take a clinical approach to my major cross-cultural teaching and research involvements. The theoretical framework elaborated in this book has been applied to all of those areas; in turn, they are used to illustrate the theory. Both the theory and its application embody the same dialectic. The purpose of this book is to advance both poles of that dialectic: to demonstrate the critical role of social science (especially anthropology and cross-cultural studies) in clinical medicine and psychiatry and to encourage study of clinical problems by anthropologists and other investigators involved in cross-cultural research.
List of Figures
1. Orientations 1: The Problem, the Setting, and the Approach
2. Orientations 2: Culture, Health Care Systems, and Clinical Reality
3. Orientations 3: Core Clinical Functions and Explanatory Models
4. The Cultural Construction of Illness Experience and Behavior, 1: Affects and Symptoms in Chinese Culture
5. The Cultural Construction of Illness Experience and Behavior, 2: A Model of Somatization of Dysphoric Affects and Affective Disorders
6. Family-Based Popular Health Care
7. Patients and Healers: Transactions Between Explanatory Models and Clinical Realities. Part 1. Sacred Folk Healer-Client Relationships
8. Patients and Healers: Transactions Between Explanatory Models and Clinical Realities. Part 2: Professional Practitioner-Patient and Family-Patient Relationships
9. The Healing Process
10. Epilogue: Implications
Arthur Michael Kleinman, M.D. is Professor of Medical Anthropology in the Department of Social Medicine at Harvard University.
"Kleinman, a psychiatrist, trained in anthropology, reports on his studies of health care in Taiwan. He describes his observations of clinical interviews between various medical practitioners-folk-healers, temple medicine men, and Chinese-style and Western-style physicians-and their patients. Throughout this fascinating and thought-provoking account, the author stresses the importance of adopting the proper cultural perspective, making one's interpretations within that framework, and relying on direct observation. Kleinman is adept at setting the cultural context and acute in identifying the important points. His use of the 'explanatory model' and 'clinical reality' in his interpretation and discussion clarifies what otherwise might be diffuse and confusing situations." --Library journal "An exploration of the controversial borderland between psychiatry, medicine and medical anthropology. Professor Kleinman, with his feet firmly based in all three camps, has succeeded in writing a scholarly book which will reward a careful reader .... The author urges an integration of social and cultural methods into the routine training of doctors, so as to enable a more humane and appropriate clinical practice .. . . it can only be hoped that the doors of the various departments, including departments of psychiatry, will be open and that this challenge will be responded to."--British journal of Psychiatry "His experiences are not the point of his story; they serve to illuminate. His personal picture of Taiwan's health care is embedded in a matrix of argument. His aim is to convince us that we must study the whole of a culture to understand its health care, that a system of health care includes every healer and belief, no matter how foreign to the dominant practice, that common features of health-care systems can be derived from comparing them, and that these common features are instructive about health care and about our own systems." --New England journal of Medicine