Sickness as Cultural Semantics: Issues for an Anthropological Medicine and Psychiatry

Abstract

One of the chief contributions of several decades of anthropological research is the recognition that culture exerts its most powerful effect on health and sickness through the categories it creates to label and explain behavior (cf. Eisenberg, 1977; Fabrega, 1974; Good, 1977; Kleinman, 1977a). Those cultural categories guide the labeling of behavior as normal or deviant, and, if the latter, determine whether it is labeled medical or nonmedical deviance (Waxier, 1974). When a sickness label is affixed to a person’s behavior, cultural categories engender the distinctive conceptualizations the patient, his family, and his caregivers employ to name, valuate, and decide upon a treatment response, often in quite different and at times even conflicting ways. Indeed, much recent medical anthropological research demonstrates that the sick individual’s “illness behavior” reflects the influence of cultural categories on conceptions of the body and its functions, perception and expression of symptoms, the social sanctioning of a particular type of sick role, and the significance attributed to the sickness (Fabrega, 1974; Klein- man, 1977b).