Issue Preview

Welcome back to our two-week special update featuring glimpses into some of the articles published in the latest release of Culture, Medicine, and Psychiatry. These brief synopses of a few of our newest pieces from the September 2014 issue are only some of the publications that the current issue has to offer. We hope they invite you to explore the many other fascinating articles housed in this issue and in past volumes of CMP.

Swapnaushadhi: The Embedded Logic of Dreams and Medical Innovation in Bengal
Projit Bihari Mukharji

Mukharji’s article discusses the prevalent but little-researched history of indigenous therapeutic practices in Bengal that stem from therapies revealed in healers through dreams. Instead of grouping this practice into the indiscriminate category of “indigenous practice” or “dream culture,” the author asserts that all dream cultures are locally specific. They also do not draw stringent religious boundaries, as healers (and their patients) may receive visions of divine figures like Jesus or Muhammed despite not being of the creed the prophet represents. Because of this cross-cultural and “borderless” dialogue, medical innovation in dream medicine occurs regularly as the product of contact between numerous religious, spiritual, and local traditions. As Mukharji argues, “the logic of dreams opens up a space: the swapna-sthana or the dreamland where such cross-boundary transactions can take place without undermining the sanctity of the boundary itself in everyday social life.”

‘‘Pensando Mucho’’ (‘‘Thinking Too Much’’): Embodied Distress Among Grandmothers in Nicaraguan Transnational Families
Kristin Elizabeth Yarris

Yarris chronicles the difficulties faced by Nicaraguan grandmothers serving as the primary caregivers of grandchildren whose mothers have migrated to another country for employment. The author asks us to reconsider the simplistic mind-body connection in lieu of a more complicated view of the body and mind as experiencing distress: physical, emotional, and cultural all at once. In this paper, we discover that the term “thinking too much” ultimately describes the difficult self-sacrifice faced by grandmothers who tend to their grandchildren to allow their own children to succeed elsewhere. The stress of geographically dispersed and fractured families, the burden of caregiving later in life, and anxieties surrounding the grandmothers’ “hopes for the future” generate a particular form of psychosomatic suffering connected to broader economic, social, and political pressures manifested at the local level among these Nicaraguan families.

Welcome back to the CMP blog! For the next two weeks we will post short descriptions of our newest articles from September 2014, which includes a special section addressing medical learning in South Asia as well as other thought-provoking pieces in the cultural construction of medicine, health, and illness. These updates are intended to offer a taste of the research we’re excited to share with you through the journal.

Knowledge and Skill in Motion: Layers of Tibetan Medical Education in India
Laurent Pordié & Calum Blaikie

In this article, the authors discuss the various ways that a student can be trained in Tibetan medical practice. They argue that there is not one means of medical training for Tibetan medicine, but rather numerous means of learning that alter the way the Tibetan practitioners learn and deliver medical care. In particular, three means of learning are highlighted: traditional apprenticeship under a Tibetan medical caregiver, classroom learning through a Buddhist institute, and lastly at a Tibetan medical organization intended to educate future practitioners from poorer rural regions with fewer resources than those attending the elite Buddhist school. The argument weighs the prestige and the social acceptance of each methods of training, noting that “institutionalisation tends to relegate ‘traditional training’ to an inferior level, in particular due to its heterogeneity and the social image of rural backwardness it presents.” It also addresses how different forms of learning are legitimated by the government and local authorities, and demonstrates the shift from skill-based learning via apprenticeship towards formal, institutional learning that emphasizes education over “enskillment.”

Of Shifting Economies and Making Ends Meet: The Changing Role of the Accompagnant at the Fann Psychiatric Clinic in Dakar, Senegal
Katie Kilroy-Marac

Kilroy-Marac draws from her ethnographic research in Senegal to offer a vivid picture of the shift in the role of the accompagnant, an attendant who stays with mental health patients for the duration of their hospitalization. Although this attendant was in previous generations a family member of the patient, there has been a sudden rise in professional accompagnants who are paid to stay with the patient at the clinic. The author notes that the “neoliberal turn” in Senegal towards increased wealth and commodification of services is exemplified in the professional accompagnant, whose services form a monetary transaction in lieu of fulfilling a familial duty to the patient: providing work for others and freeing up families who, in the newly-bolstered economy, often have other career and personal obligations. However, the author complicates this notion by noting how much the families cherish the attendant’s work and offer them gifts outside of typical payment agreements, and how these connections can often be special between families and the accompagnants.