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The Touch of Madness - Pacific Standard
"So Jones grew alarmed when, soon after starting at DePaul in the fall of 2007, at age 27, she began having trouble retaining things she had just read. She also struggled to memorize the new characters she was learning in her advanced Chinese class. She had experienced milder versions of these cognitive and memory blips a couple times before, most recently as she’d finished her undergraduate studies earlier that year. These new mental glitches were worse. She would study and draw the new logograms one night, then come up short when she tried to draw them again the next morning.

These failures felt vaguely neurological. As if her synapses had clogged. She initially blamed them on the sleepless, near-manic excitement of finally being where she wanted to be. She had wished for exactly this, serious philosophy and nothing but, for half her life. Now her mind seemed to be failing. Words started to look strange. She began experiencing "inarticulable atmospheric changes," as she put it—not hallucinations, really, but alterations of temporality, spatiality, depth perception, kinesthetics. Shimmerings in reality's fabric. Sidewalks would feel soft and porous. Audio and visual input would fall out of sync, creating a lag between the movement of a speaker's lips and the words' arrival at Jones' ears. Something was off.

"You look at your hand," as she described it to me later, holding hers up and examining it front and back, "and it looks the same as always. But it's not. It's yours—but it's not. Nothing has changed"—she let her hand drop to her knee—"yet it's different. And that's what gets you. There's nothing to notice; but you can't help but notice."

Another time she found herself staring at the stone wall of a building on campus and realizing that the wall's thick stone possessed two contradictory states. She recognized that the wall was immovable and that, if she punched it, she'd break her hand. Yet she also perceived that the stone was merely a constellation of atomic particles so tenuously bound that, if she blew on it, it would come apart. She experienced this viscerally. She felt the emptiness within the stone.

Initially she found these anomalies less threatening than weird. But as they intensified, the gap between what she was perceiving and what she could understand rationally generated an unbearable cognitive dissonance. How could something feel so wrong but she couldn't say what? She had read up the wazoo about perception, phenomenology, subjectivity, consciousness. She of all people should be able to articulate what she was experiencing. Yet she could not. "Language had betrayed me," she says. "There was nothing you could point to and say, 'This looks different about the world.' There were no terms. I had no fucking idea."

Too much space was opening within and around and below her. She worried she was going mad. She had seen what madness looked like from the outside. When Jones was in her teens, one of her close relatives, an adult she'd always seen frequently, and whom we'll call Alex for privacy reasons, had in early middle age fallen into a state of almost relentless schizophrenia. It transformed Alex from a warm, caring, and open person who was fully engaged with the world into somebody who was isolated from it—somebody who seemed remote, behaved in confusing and alarming ways, and periodically required hospitalization. Jones now started to worry this might be happening to her."



"Reading philosophy helped Jones think. It helped order the disorderly. Yet later, in college, she lit up when she discovered the writers who laid the philosophical foundation for late 20-century critical psychiatry and madness studies: Michel Foucault, for instance, who wrote about how Western culture, by medicalizing madness, brands the mad as strangers to human nature. Foucault described both the process and the alienating effect of this exclusion-by-definition, or "othering," as it soon came to be known, and how the mad were cut out and cast away, flung into pits of despair and confusion, leaving ghosts of their presence behind.

To Jones, philosophy, not medicine, best explained the reverberations from the madness that had touched her family: the disappearance of the ex-husband; the alienation of Alex, who at times seemed "there but not there," unreachable. Jones today describes the madness in and around her family as a koan, a puzzle that teaches by its resistance to solution, and which forces upon her the question of how to speak for those who may not be able to speak for themselves.

Jones has since made a larger version of this question—of how we think of and treat the mad, and why in the West we usually shunt them aside—her life's work. Most of this work radiates from a single idea: Culture shapes the experience, expression, and outcome of madness. The idea is not that culture makes one mad. It's that culture profoundly influences every aspect about how madness develops and expresses itself, from its onset to its full-blown state, from how the afflicted experience it to how others respond to it, whether it destroys you or leaves you whole.

This idea is not original to Jones. It rose from the observation, first made at least a century ago and well-documented now, that Western cultures tend to send the afflicted into a downward spiral rarely seen in less modernized cultures. Schizophrenia actually has a poorer prognosis for people in the West than for those in less urbanized, non-Eurocentric societies. When the director of the World Health Organization's mental-health unit, Shekhar Saxena, was asked last year where he'd prefer to be if he were diagnosed with schizophrenia, he said for big cities he'd prefer a city in Ethiopia or Sri Lanka, like Colombo or Addis Ababa, rather than New York or London, because in the former he could expect to be seen as a productive if eccentric citizen rather than a reject and an outcast.

Over the past 25 years or so, the study of culture's effect on schizophrenia has received increasing attention from philosophers, historians, psychiatrists, anthropologists, and epidemiologists, and it is now edging into the mainstream. In the past five years, Nev Jones has made herself one of this view's most forceful proponents and one of the most effective advocates for changing how Western culture and psychiatry respond to people with psychosis. While still a graduate student at DePaul she founded three different groups to help students with psychosis continue their studies. After graduating in 2014, she expanded her reach first into the highest halls of academe, as a scholar at Stanford University, and then into policy, working with state and private agencies in California and elsewhere on programs for people with psychosis, and with federal agencies to produce toolkits for universities, students, and families about dealing with psychosis emerging during college or graduate study. Now in a new position as an assistant professor at the University of South Florida, she continues to examine—and ask the rest of us to see—how culture shapes madness.

In the United States, the culture's initial reaction to a person's first psychotic episode, embedded most officially in a medical system that sees psychosis and schizophrenia as essentially biological, tends to cut the person off instantly from friends, social networks, work, and their sense of identity. This harm can be greatly reduced, however, when a person's first care comes from the kind of comprehensive, early intervention programs, or EIPs, that Jones works on. These programs emphasize truly early intervention, rather than the usual months-long lag between first symptoms and any help; high, sustained levels of social, educational, and vocational support; and building on the person's experience, ambitions, and strengths to keep them as functional and engaged as possible. Compared to treatment as usual, EIPs lead to markedly better outcomes across the board, create more independence, and seem to create far less trauma for patients and their family and social circles."



"Once his eye was caught, Kraepelin started seeing culture's effects everywhere. In his native Germany, for instance, schizophrenic Saxons were more likely to kill themselves than were Bavarians, who were, in turn, more apt to do violence to others. In a 1925 trip to North America, Kraepelin found that Native Americans with schizophrenia, like Indonesians, didn't build in their heads the elaborate delusional worlds that schizophrenic Europeans did, and hallucinated less.

Kraepelin died in 1926, before he could publish a scholarly version of those findings. Late in his life, he embraced some widely held but horrific ideas about scientific racism and eugenics. Yet he had clearly seen that culture exerted a powerful, even fundamental, effect on the intensity, nature, and duration of symptoms in schizophrenia, and in bipolar disorder and depression. He urged psychiatrists to explore just how culture created such changes.

Even today, few in medicine have heeded this call. Anthropologists, on the other hand, have answered it vigorously over the last couple of decades. To a cultural anthropologist, culture includes the things most of us would expect—movies, music, literature, law, tools, technologies, institutions, and traditions. It also includes a society's predominant ideas, values, stories, interpretations, beliefs, symbols, and framings—everything from how we should dress, greet one another, and prepare and eat food, to what it means to be insane. Madness, in other words, is just one more thing about which a culture constructs and applies ideas that guide thought and behavior.

But what connects these layers of culture to something so seemingly internal as a person's state of mind? The biocultural anthropologist Daniel Lende says that it helps here to think of culture as a series of concentric circles surrounding each of us. For simplicity's sake, let's keep it to two circles around a core, with each circle … [more]
2017  daviddobbs  mentalhealth  psychology  health  culture  madness  nevjones  japan  ethiopia  colombo  addisababa  schizophrenia  society  srilanka  shekharsaxena  philosophy  perception  treatment  medicine  psychosis  media  academia  anthropology  daniellende  pauleugenbleuler  emilkraepelin  danielpaulschreber  edwadsapir  relationships  therapy  tinachanter  namitagoswami  irenehurford  richardnoll  ethanwatters  wolfgangjilek  wolfgangpfeiffer  stigma  banishment  hallucinations  really  but  alterations  of  temporality  time  spatiality  depthperception  kinesthetics  memory  memories  reality  phenomenology  subjectivity  consciousness  donaldwinnicott  alienation  kinship  isolation  tanyaluhrmann 
3 days ago by robertogreco
Twitter
Image of Ethiopia (4.95, 40.95) from the 7th of March, 2017
Ethiopia  space  ESA  EU  Sentinel  from twitter_favs
17 days ago by briantrice
Gebre - Wikipedia
Gebreselassie ("Servant of the Trinity"), Gebremeskel ("Servant of the Cross"), or Gebremariam ("Servant of Mary"). Gebru is a variant, often seen in Tigrinya.
ethiopia  ethiopian_orthodox 
7 weeks ago by benjekman
Journalists under duress: Internet shutdowns in Africa are stifling press freedom
"The internet for journalism is now like the air you breathe. Without the internet, modern journalism means nothing," says Ethiopian journalist and Zone 9 blogger Befeqadu Hailu. "Yet," writes Jonathan Rozen for Africa Portal, "the internet is something that journalists in multiple African countries are often forced to do without," chronicling recent shutdowns in Ethiopia, Congo-Brazzaville, and Cameroon, along with civil society and advocacy efforts to resist such shutdowns.
otf  africa  ethiopia  congo  cameroon  shutdown  access 
8 weeks ago by dmcdev
Twitter
Incredible new adventure! Arrived in 2day for 1st workshop organised with M…
Ethiopia  ESC  from twitter_favs
9 weeks ago by mozillascience

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