Selfhood and social distance: toward a cultural understanding of psychiatric stigma in Egypt
Author: Coker EM.
Source:
Social Science & Medicine, 61(5), 920-930.
Psychiatric stigma is a concept that is often used uncritically by policy-makers
to explain the underutilization of professional psychiatric services in
non-Western societies. Stigma, however, is a multi-determined process
manifestations and effects of which cannot be viewed separately from the larger
social and cultural context. The present paper presents the results of a
qualitative study of psychiatric stigma in Egypt from the perspective of lay
respondents. A vignette method was used to elicit judgments of social distance
and qualitative responses to stories depicting psychosis, depression, alcohol
abuse and a 'possession state' from 208 respondents recruited through their
places of work. The results indicated that while stigma does exist in Egypt, the
form that it takes must be understood with reference to Egyptian notions of
selfhood that locate behavioral disturbances in the intersubjective rather than
intrapsychic realm. On the one hand, individual blame is diffused as
responsibility for the illness and its cure is placed in the social, not personal
(or biological) realm. On the other, behavioral disorders that threaten the
social fabric of society are particularly stigmatized and often met with social
rejection.