Culture-bound syndrome and a culturally sensitive approach: From a viewpoint of medical anthropology

Some aspects of the culture-bound syndrome are presented for discussion. Fr om the psychiatric and medical anthropological viewpoints, kamidaari is des cribed as an initiatory illness for seeing a shaman, and focus on clinical realities developing between different therapeutic subcultures in the same culture and the complementary practices of two epistemological ones, namely , the shamanistic and modern psychiatric system in the shamanistic climate. It is suggested that the culture-bound syndrome that reflects cultural inf luences on disease patterns and renders them difficult to place in a univer sal classificatory system should be seen as a vernacular bricolage or as ta ctics used by people within the web of their own local culture of origin. T herapists who treat patients in a cross-epistemological milieu should be aw are of the subcultural-epistemological issues that may affect the clinical process. It should be recognized that, depending on the nature of a particu lar psychiatric crisis, the clinical encounter is straddling the boundaries of multiple clinical realities. At every stage in the clinical field, ther e is an intersection, consonance, or interruption of rejoinders in the open dialog by all those engaged in the clinical time. Aspects of climatic, cul turally sensitive psychotherapy will be described, and the concept of the c ulture-bound syndrome will be reconsidered. Our approach could be seen as ' situation- and fudo-bound'.