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Navigating Diagnoses: Understanding Mind–Body Relations, Mental Health, and Stigma in Nepal

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Abstract

Anthropologists and psychiatrists traditionally have used the salience of a mind–body dichotomy to distinguish Western from non-Western ethnopsychologies. However, despite claims of mind–body holism in non-Western cultures, mind–body divisions are prominent in non-Western groups. In this article, we discuss three issues: the ethnopsychology of mind–body dichotomies in Nepal, the relationship between mind–body dichotomies and the hierarchy of resort in a medical pluralistic context, and, finally, the role of mind–body dichotomies in public health interventions (biomedical and psychosocial) aimed toward decreasing the stigmatization of mental illness. We assert that, by understanding mind–body relations in non-Western settings, their implications, and ways in which to reconstitute these relations in a less stigmatizing manner, medical anthropologists and mental health workers can contribute to the reduction of stigma in global mental health care.

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Notes

  1. The names of all those represented in this article have been changed to preserve anonymity.

  2. Man (heart–mind) is italicized throughout the manuscript, in contrast to the AAA Style Guide, to prevent confusion between English man and Nepali man.

  3. A man in Kathmandu said, “We do not use saato as an element by itself, but rather only in the phrase of saato gayo [soul loss].”

  4. Paramedical health workers and nurses are also an important health resource in Nepal. Increasingly, paramedical health workers and nurses are foci of mental health trainings. However, due to space limitations this will be addressed in future work.

  5. A multidenominational protestant endeavor, the United Mission to Nepal (UMN), established a Christian Mission on the widest cooperative basis, one which by 1999 had 34 member bodies and 17 affiliated member bodies based in the United States, the United Kingdom (Scotland, England), Australia, India, Germany, Japan, Norway, Canada, Ireland, Denmark, Finland, Sweden, Switzerland, Korea, Philippines, Netherlands, and Singapore (UMN 1999). For more on the history of the UMN and this hospital, see Harper (in press).

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Acknowledgments

Portions of this paper were presented at the CNAS seminar at Tribhuvan University and the SAHI seminar at the University of Edinburgh. We thank the participants in these seminars as well as Peter Brown, Christina Chan, Mark Jordans, Sara Shneiderman, Wietse Tol, Lotje van Leeuwen, Sienna Craig, Stefan Ecks, and Carol Worthman for their contributions to this article. The first author was funded by an NIMH National Research Service Award, the Wenner-Gren Foundation, and Emory University Graduate School of Arts and Sciences. The second author was funded by the Economic Social Research Council (ESRC) between 1998–2000. Some of the insights and material also draw on research funded as part of the ERSC/DFID joint research grants scheme (RES-167-25-0110) under the title ‘Tracing Pharmaceuticals in South Asia’ and held at the University of Edinburgh's Centre for South Asian Studies. Martin Chautari, (Kathmandu) provided resources and assistance drawn upon in writing this paper. Neither ESRC nor DFID is responsible for views advanced here.

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  1. Department of Anthropology, Emory University, 1557 Dickey Drive, Atlanta, GA, 30322, USA

    Brandon A. Kohrt

  2. School of Social and Political Studies, University of Edinburgh, Edinburgh, Scotland, UK

    Ian Harper

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Correspondence to Brandon A. Kohrt.

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Kohrt, B.A., Harper, I. Navigating Diagnoses: Understanding Mind–Body Relations, Mental Health, and Stigma in Nepal. Cult Med Psychiatry 32, 462–491 (2008). https://doi.org/10.1007/s11013-008-9110-6

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