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1 Orientations

Stacey A. Langwick Indiana University Press ePub

This book is a study of healing practices in southeastern Tanzania and the worlds they render meaningful and concrete. The World Health Organization (2002) estimates that 80 percent of Africans have sought out traditional medicine and states that many depend on herbal remedies as a critical aspect of their primary health care.1 Some African health professionals, including the district nursing officer in Newala, where I conducted the majority of the fieldwork for this book, suggest that the use of traditional medicine is on the rise due to the inadequacy of health care services under the growing economic pressures of neoliberal reform. The incorporation of traditional medicine and healers into health development goals raises the question of how to describe the efficacy of such therapies. This includes how to account for happenings that are salient to many therapeutic experiences but are discounted by biomedicine. Often the entities that healers claim to be treating—mischievous spirits, troublesome devils, disgruntled ancestors, the embodiments of human jealousies and greed—are not recognized by medical science, and the transformations that healers effect cannot be confirmed through biomedical procedures. Yet when Binti Dadi tests the toxicity of a new potential medicine on a rat and when Kalimaga keeps careful records of those who use his medicine in the name of “clinical trials,” these healers refuse to observe the familiar boundaries between science and nonscience.2 Rather they reflect the ways that colonization, missionization, postcolonial state building, international development, and transnational capitalism have shaped the practices known as healing in Newala today.

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Medium 9781855754195

10: The king’s castle, the mother’s rucksack. The wish for the Other on facing death

Michael Gunter Karnac Books ePub

Klaus was an eight-year-old boy when I first met him. He was suffering from a neuroblastoma, a malignant tumour of the nerve tissues. He was to be admitted to the children ’s clinic for a bone marrow transplant. The family was socially isolated, the mother came from a different culture and did not speak German particularly well. The boy had had practically no social contact with his peer group as a result of his illness, as I discovered after the first interview. He had been to kindergarten only for a few months before becoming ill; he had not gone on to attend school. When we met for the first time about a week before his planned admission, he seemed withdrawn, lacking in vitality and anxiously reserved. The first squiggle pictures were characterised by the fact that parts of the lower body were missing: in some cases the animals had no legs. Interspersed were pictures in which body parts were twisted, and there were indications of a psychic dedifferentiation. Gradually I managed to get into conversation with the boy. He began to open up a little and talked about how sad he was to be so isolated socially, while his younger sister was able to go to school. He opened up to the point of being able to speak about his fear of what was to come. Towards the end of our conversation he seemed increasingly to have rebuilt his encircling wall, and drew as his final picture (fig. 10–1) a person with a lot of hair—just think of chemotherapy and the associated loss of hair—whose legs seemed, however, to be missing.

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Medium 9781855759077

CHAPTER TWO: Outlines of psychodynamic under fives’ counselling and theoretical background

Maria Pozzi Monzo Karnac Books ePub


The model I describe in this book is based on the Under Fives’ Counselling Service founded at the Tavistock Clinic in the eighties. It is rooted in the belief, the experience, and knowledge that early intervention has a curative, as well as a preventative, effect. The emotional difficulties of young children are expressed in physical and behavioural symptoms that are closely linked with the developmental phases of infancy and early childhood. Parents come to Child and Family Psychiatric Clinics or consult child psychotherapists privately with a variety of complaints. We encounter infants who do not feed, cry incessantly or never settle into a sleep pattern. We see children who do not learn to talk, cannot be toilet-trained, refuse to separate from their mother or do not settle at playgroup. We also see children who are hyperactive, violent, isolated or excessively shy.

The Under Fives’ Counselling Service offers up to five sessions to the parents and child, who can refer themselves to the clinic directly or be referred by their health visitors or doctors. Most of the families I discuss in the book have been seen in N.H.S. services or privately in England and abroad. The therapeutic model is also rather flexible (Miller, 1992), as it reflects and adapts to the needs of families of this age group. Flexibility and improvisation are often required by parents to deal with the intensity of passions and urgency of needs of their under fives. Similarly, although it is preferable to meet the whole family and work with both parents, the counselling accommodates individual needs of attendance and frequency. The gap between sessions also varies according to the needs of each family and such issues are carefully explored together with the therapist.

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Medium 9781780644554

9: Psychosocial and Mental Health Care Before, During and After Emergencies, Disasters and Major Incidents

Wapling, A. CABI PDF


Psychosocial and Mental Health

Care Before, During and After

Emergencies, Disasters and Major


R. Williams1 and V. Kemp2

Emeritus Professor of Mental Health Strategy, Welsh Institute for Health and

Social Care, University of South Wales, Pontypridd, UK


Director, Healthplanning Ltd; and Associate, Welsh Institute for Health and

Social Care, University of South Wales, Pontypridd, UK


Key Questions 

• What do the terms ‘psychosocial’, ‘psychosocial care’ and ‘mental health care’ mean?

• �Why is it important for emergency planners to understand the psychosocial and mental health needs of people affected by emergencies?

• �What are the basic principles of psychological first aid?

• �Are professional responders, including health care staff, less likely than members of the public to suffer the psychosocial and mental health impacts of emergencies?

9.1  Introduction

This chapter is intended as a basic briefing to assist health and social care organizations begin to take steps to prepare their staff and services for the psychosocial and mental health impacts of all kinds of emergencies, major incidents and disasters. This includes preparing for pandemic influenza, serious infectious illnesses, major terrorist events, and marauding terrorist firearms incidents. These plans, and the services required to deliver them, should be fully integrated into wider arrangements for emergency preparedness, resilience and response (EPRR).

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6 Neutralizing Morality: Nondirective Counseling of Parents of Children with Intersex Conditions, 2006–

Ellen K. Feder Indiana University Press ePub

Among the Most significant changes in the standard of care for children born with sex anomalies has been the definitive move away from what Cheryl Chase characterized in the late 1990s as a “concealment-centered model” of care for children with DSD (Chase with Dreger 2000). Before the publication of the Consensus Statement in 2006, physicians cautioned parents against open discussion of a child’s condition with extended family or friends in order to protect the child from potentially harmful comments that could damage her psychosexual development. The risk posed by such comments was understood as a threat to the “concordance” a child ought to experience between the appearance of her body and her assigned sex. It was for this same reason that parents were also advised not to discuss the child’s condition with the child herself (B. Wilson and Reiner 1998, 363). Today there is little question that the revised standard requires physicians to honestly and forthrightly discuss with parents the nature of their children’s conditions. The paternalism that prevailed during most of the second half of the twentieth century in the experiences of the families I discussed in chapter 2 is increasingly a thing of the past.

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