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technical paper
Figurations of Distress, Glocal Nosologies and Non-Verbal Communication in Global Mental Health
keywords:
decolonization
mental health
ethics
Recent global mental health debates have focused on the challenges of acknowledging the diversity of local experiences of distress. Emic-etic, hybrid, glocalized, flexible and integrative approaches have been proposed to find the optimal balance between universalizing and localized categories. One of the most compelling challenges concerns how to elicit local interpretations of mental suffering without imposing a normative, Western-biased communicative protocol. Questionnaires, scales, semi-structured interviews and survey guidelines have been implemented and, in some occasions, integrated in the mainstream Western biomedical and psychiatric systems of classification (e.g. the Cultural Formulation Interview, CFI, in the DSM-5, 2013). Most if not all these tools rely essentially on verbalization. Marginal attention has been dedicated to non-verbal communication. Nevertheless, growing evidence shows that verbalization is not necessarily the most adequate way of communicating distress in many societies, where other strategies (e.g. strategic silence, ritualization, figuration) may be more culturally appropriated. How to integrate non-verbal communication in ethnographic practice and cross-cultural psychiatry? My ethnographic focus is a form of demonic possession (grisi siknis) diffused prevalently among Miskito women of Caribbean Nicaragua and Honduras. During fieldwork, I communicated with those affected by grisi siknis through their drawings of demons. The figurative process proved to be also effective for coping and, in several occasions, for healing. I develop theoretical considerations and a preliminary research agenda to explore further the interplay between non-verbal communication, glocal nosologies, experimental ethnography and the cultural diversity of distressing experience.