APPLIED APPROACH
The applied approach refers to the research and analysis that is done on one subject – or illness – dealing with a specific client. Anthropologists who use this approach are "trained in anthropological theory in order to look at the macro level structures in tandem with the micro level experiences" (Karim, Lecture 6.1). This helps contextualize the illness or problem as well as identify any possible barriers. Those utilizing this approach often are trained in interdisciplinary methods and qualitative methods.
Often times, those who work in global health or clinical anthropology are using this anthropological approach. This approach also incorporates the other approaches (biological, ecological, ethnomedical, experiential, and critical) and anthropological theory, which would result in a more holistic contextualization of illnesses.
Often times, those who work in global health or clinical anthropology are using this anthropological approach. This approach also incorporates the other approaches (biological, ecological, ethnomedical, experiential, and critical) and anthropological theory, which would result in a more holistic contextualization of illnesses.
GLOBALIZATION AND HEALTH
Globalization refers to the ever-growing connections and interdependencies occurring on an international scale; it "considers the complex interactions between cultures, economic systems, political organizations, and planetary ecology" (Karim, Lecture 6.1). While it is great that information is now being shared on an international scale and that it has increased free trade between the nations and free movement of labor. But these aren't necessarily always positives – especially when you are looking at countries that have actually become disadvantaged by the things that make globalization so great. Because of globalization, many in developing countries now have to deal not only with the illnesses that are prevalent among developing countries (malaria, malnutrition, etc.) but also the illnesses that are prevalent among the richer nations (heart disease, diabetes, etc.). The image to the left depicts this prevalence of these developed nation illnesses as well as how it will effect the poor and middle-income nations economically; according to the figure, the total burden would be $7.3 trillion (Figure 1).
In addition to that, the way illnesses are perceived and treated now primarily use Western biomedical interventions. This is not good. Dr. Sing Lee, a researcher and psychiatrist and the Chinese University of Hong Kong, stated: "As Western categories for diseases have gained dominance, micro-cultures that shape the illness experiences of individual patients are being discarded. The current has become too strong" (Watters, 2010). One of the more interesting points I think that Watters makes in his article "The Americanization of Mental Illness" is how we do not view Western understandings of mental illnesses as cultural-bound syndromes as we would other cultures. Due to globalization, the dominance of Western biomedical thought is usurping the narratives and understandings formed in other cultures. In his article, Watters writes:
For more than a generation now, we in the West have aggressively spread our modern knowledge of mental illness around the world. We have done this in the name of science, believing that our approaches reveal the biological basis of psychic suffering and dispel prescientific myths and harmful stigma. There is now good evidence to suggest that in the process of teaching the rest of the world to think like us, we've been exporting our Western "symptom repertoire" as well. That is, we've been changing not only the treatments but also the expression of mental illness in other cultures. |
I am unsure about how bipolar disorder specifically as been impacted by globalization but I can only assume, based off of the "Americanization" of mental illnesses, that the way it is culturally understood has surely changed to fit the American or Western mold.
IN THE FIELD
Emily Martin, an anthropologist, wrote a book entitled Bipolar Expeditions: Mania and Depression in American Culture based off of her own experiences with bipolar disorder. In this book, she looks at how mania and depression exist outside of the medical contexts and how they manifest themselves via the concepts of rationality and insanity. Though I was unable to read the book, I did read Grinker's book review in Anthropology Quarterly so I was able to get some insight into the specifics. In his book review, he points out how Martin creates the link between mania and economic success and rationality which has become more popular in Western society. "Manic behavior is increasingly linked with economic rationality, and idealized in the widespread images of figures such as equities traders who stay up all night, or the risk-taking entrepreneur involved with multiple ventures at the same time" (Grinker, 2008). Additionally, he emphasizes a section in Martin's book where she finds that at bipolar support group meetings, individuals would express themselves using the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) language rather than in a more personal and symbolic way. It is interesting the way scientific framework has not only framed how we view illnesses but also how we discuss them – our personal illness narratives are being affected by this. Martin is using the critical approach to examine this.
This book seems like a very insightful look into how bipolar disorder and its symptoms exist in American culture. To the right is an image of what the book looks like (Figure 2). |
THE DEPRESSION AND BIPOLAR SUPPORT ALLIANCE
The Depression and Support Alliance (DBSA) is an organization dedicated to creating support groups for those who have depression and/or bipolar disorder. These illnesses are quite isolating so DBSA is there to help you connect with others. DBSA offers a variety of options: they have resources to educate yourself and others on mental health; they provide information on different treatment options to help you find the best approach; they have support group information and locators to help you find your support system; they have outlets for those with depression and/or bipolar disorder to publish on their site to discuss what they have gone through or are going through; they offer resources to help others with mental illnesses; and they have 65-member Scientific Advisory committee consisting of leading researchers and clinicians in mood disorders, which helps foster better communication between the individual and their clinician and/or other professionals (DBSA).
This organization also utilizes the experiential approach through it's use of the illness narratives and lived experiences. I think this is a great organization that offers help and support to those who need it as well as providing important information about treatment options, support group information, better clinician-patient interaction, etc. However, this organization largely focuses on the Western biomedical perspective on bipolar disorder. It does not include much information about alternative treatment options, offering more information about the latest medications and behavioral therapies. I recognize that this is due to the fact that DBSA is an American organization which is, for the most part, catering to the homogenized American public.
This organization also utilizes the experiential approach through it's use of the illness narratives and lived experiences. I think this is a great organization that offers help and support to those who need it as well as providing important information about treatment options, support group information, better clinician-patient interaction, etc. However, this organization largely focuses on the Western biomedical perspective on bipolar disorder. It does not include much information about alternative treatment options, offering more information about the latest medications and behavioral therapies. I recognize that this is due to the fact that DBSA is an American organization which is, for the most part, catering to the homogenized American public.
THE IMPORTANCE OF MEDICAL ANTHROPOLOGY
Having some sort of grounding in medical anthropology is absolutely necessary, especially if you are working in the health sector. Anthropological knowledge provides one with the tools to be able to see more holistically as well as to be able to recognize and accept other culture's ways of viewing and treating illnesses. I believe that medical anthropology does a lot to dispel the notion that biomedicine is the best option. When you have clinicians and other professionals going into different communities and cultures with this Western biomedicine superiority complex, it would not be conducive at all for the relationship between the community and the clinicians as well as for providing treatment and care. If we do not understand how the illnesses are culturally constructed in whichever community, it will definitely hamper the effectiveness of the treatment. Just because we treat X illness a certain way in the U.S. does not mean it will go over as effectively in another community/culture.
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To the right is a YouTube video by Tribal Jazzman Scholar on medical anthropology. I wanted to include it because he makes some very important points about the necessity of medical anthropology. One of the examples he offers is of an organization providing IUDs to women in a Peruvian village to help with family planning. This organization neglected to take into account this village's culture ergo they did not realize that when women were menstruating, they were not allowed to handle food. When these women would use the IUD, it would increase the severity and duration of their periods; this negatively impacted the collective health of the community. Just based off of this example alone, you can see the importance of understanding the cultural contexts of the communities that you are helping as it will allow you to discern whether or not your assistance will positively or negatively impact their health.
Now that you have learned about the Applied Approach, you have officially read about all the approaches that I learned in ANP 204 – that is, if you read them in linear fashion. If you want to learn more about ANP 204, please click here.
Now that you have learned about the Applied Approach, you have officially read about all the approaches that I learned in ANP 204 – that is, if you read them in linear fashion. If you want to learn more about ANP 204, please click here.
REFERENCE(S)
"Depression and Bipolar Support Alliance." Depression & Bipolar Support Alliance. Web. Aug. 2014.
Grinker, Roy Richard. "Book Review." Anthropology Quarterly 81.2 (2008): 511-14. JSTOR. Web. Aug. 2014.
Karim, Tazin. "Lecture 6.1 Applied Medical Anthropology." ANP 2014. Lecture Notes. Aug. 2014.
Martin, Emily. Figure 2. Digital image. Princeton University Press. Princeton University, 2009. Web. Aug. 2014.
Tribal Jazzman Scholar. “”Medical Anthropology” – Tribal Jazzman Scholar, Episode #26.” YouTube. YouTube, 18 Feb. 2011. Web. Aug. 2014
Watters, Ethan. "The Americanization of Mental Illness." The New York Times. The New York Times, 09 Jan. 2010. Web. Aug. 2014.
World Economic Forum, and Harvard School of Public Health. Figure 1. Digital image. The Economist. The Economist, 24 Sept. 2011. Web. Aug. 2014.
"Depression and Bipolar Support Alliance." Depression & Bipolar Support Alliance. Web. Aug. 2014.
Grinker, Roy Richard. "Book Review." Anthropology Quarterly 81.2 (2008): 511-14. JSTOR. Web. Aug. 2014.
Karim, Tazin. "Lecture 6.1 Applied Medical Anthropology." ANP 2014. Lecture Notes. Aug. 2014.
Martin, Emily. Figure 2. Digital image. Princeton University Press. Princeton University, 2009. Web. Aug. 2014.
Tribal Jazzman Scholar. “”Medical Anthropology” – Tribal Jazzman Scholar, Episode #26.” YouTube. YouTube, 18 Feb. 2011. Web. Aug. 2014
Watters, Ethan. "The Americanization of Mental Illness." The New York Times. The New York Times, 09 Jan. 2010. Web. Aug. 2014.
World Economic Forum, and Harvard School of Public Health. Figure 1. Digital image. The Economist. The Economist, 24 Sept. 2011. Web. Aug. 2014.