Hearing Voices

Perhaps, one form of illness where telling a story of the body is most evident is in respect to mental health.

Yesterday’s ruling by the High Court’s Court of Protection, that a 69 year old lady with severe schizophrenia must receive the medical treatment for a prolapsed womb, which she has been strongly refusing and protesting against, reveals the battle that one person’s voice can hold.

Is it pathology to not fight the presence of pathology in the body?

The High Court overruled this lady’s wishes because their position viewed the lady as being overruled by something other than herself. In this respect, is our modern take on mental health, or pathology for that matter, any different from perceptions that our scientific traditions have long abandoned?

Aside from the ethical debate, which has been prompted throughout this case, there is also the issue of what shall we hear?

What words were this lady’s story? And, what words are part of the construct of her illness?

The legal ruling clearly shows that the languages of health and the languages of illness are two distinct regions for the gathering of thought.

The underlying assumption is that this lady’s mental state affected her cognitive ability to be rational, which in turn was affecting her physical condition.

Currently spending time in South East Asia, in a research environment analyzing medical ethical issues, the underlying principles of belief appears to play a significant role in constructing both the experience of a sufferer from mental illness and their relationship with modern medicine. This is an aspect that is negated by workings of a scientific model of the body, which seeks to translate abnormal physiology to the norm. How accurate is such a divide between belief and non belief in traditional and modern medicine, respectively?

The late anthropologist and GP, Cecil Helman, in his book “Tales of a Suburban Shaman”, compared some of his experiences of illness interpretations in his native South Africa with those from his medical practice in London. One passage is particularly enlightening, whereby he describes a Zulu perception of bacteria and viruses. It is not so different, Helman argues, to conceive of as a virus in terms of possession and invasion of the body by an evil spirit.

For a Western scientific model of medicine, the image of a battle within the body is a metaphor.

In traditional medicine, this metaphor is part of the fabric of a story that is told about the body.

The allocation of cause in mental illness, as it is traced through Chinese and Malay traditions, takes it back to powerful forces that have affected a person. For example, mental sickness is the result of the work of kewis (devils). It is through worshipping shen (Gods) that mental sickness can be prevented and which possess healers through trance. During a trance, diagnosis and treatment is revealed.

Across time, therefore, through orthodox to modern medicine, there is a teleology that is threaded through the story of the body.

The differences in language hide a pattern of familiarity. There is a divide between good and evil, healthy and ill, and those who are suffering from those who are cured.

In South East Asia, the meaning of mental sickness is the isolation of the presence of evil spirits, and most sufferers opt to only consult traditional healers, of whom are considered equipped to fight such a battle.

In Western countries, the meaning of mental sickness is also of causality but of organic origins, as is most forms of treatment, and not as a reflection of a person’s spiritual misgivings.

Ultimately, the body is the host. And, the person is the sole provider for their experiential narrative of perception, of introspection towards their existence, including their formation of knowledge about their various states; mental, physical, existential conditions for example.

How the person is listened to is perhaps the most telling account of medicine’s relationship with the person, prior to the evaluation of the person’s relationship to their illness, whether it be physical or mental or both. And, in light of cultural interpretations for a human response of what may be the workings of physical processes or supernatural forces, the instinct is for human protection.

How the story of a person, like this lady’s’, can be both listened to, heard and preserved in its most natural form in accordance to the nurturing of a human, and of humanity, is an endearing and forever challenging task.

[ A link to the case discussed is : http://www.dailymail.co.uk/news/article-1316418/Mentally-ill-woman-faces-life-saving-surgery-will.html ]

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