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Acts of integration, expressions of faith : madness, death and ritual in Melanau ontology : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Social Anthropology at Massey University
Longitudinal medical research studies undertaken on an international scale by the World Health Organisation continue to confirm a better prognosis for mental illness in traditional societies than in more technologically developed societies. While various associations have been drawn or hypothesised between specific cultural factors and a more favourable outcome, attention has also frequently been drawn to the methodological, analytic and diagnostic inadequacies of these studies. The work for this thesis was undertaken with these criticisms in mind and also in part as a counter to the perceived inadequacies of a solely bio-medical approach to psychopathology. The specific purpose of the research was to assess the role that culture plays in the construction and experience of both psychological well-being and psychopathology in a "traditional" society in Sarawak, Malaysia. There was an equal concern to ascertain and examine the ways in which explanations and understandings about identity, illness and wellness differ from current western models and approaches and how they are realised and lived out in the experience of individuals. The ethnographic data was collected during intensive participant-observation conducted over two years in the Mukah District of Sarawak, Malaysia, a region which has a long association with the Melanau ethnic group. Drawing on the ethnographic evidence, this thesis argues that psychopathological experiences (as psychological phenomena) embody characteristics that make it possible to identify them as culturally constructed artifacts. A theory is advanced which locates the source of psychopathology within the context of human being-in-the-world and which suggests that features of the mental illness experience such as chronicity and stigma are historically and culturally constructed within the illness concept itself. The argument draws on the theory and insights of existentialism, phenomenology. Turner's ritual theory, and Jung's concept of the shadow, extended to include a concept of the cultural shadow. It concludes that a failure to take account of the cultural dimensions of mental illness may also result in a failure to perceive not only the source of our psychopathologies but also a solution.