Culture, Medicine and Psychiatry

, Volume 5, Issue 4, pp 379–408 | Cite as

Idioms of distress: Alternatives in the expression of psychosocial distress: A case study from South India

  • Mark Nichter


This paper focuses attention on alternative modes of expressing distress and the need to analyze particular manifestations of distress in relation to personal and cultural meaning complexes as well as the availability and social implications of coexisting idioms of expression. To illustrate this point the case of South Kanarese Havik Brahmin women is presented. These women are described as having a weak social support network and limited opportunities to ventilate feelings and seek counsel outside the household. Alternative means of expressing psychosocial distress resorted to by Havik women are discussed in relation to associated Brahminic values, norms and stereotypes. Somatization is focused upon as an important idiom through which distress is communicated. Idioms of distress more peripheral to the personal or cultural behavioral repertoire of Havik women are considered as adaptive responses in circumstances where other modes of expression fail to communicate distress adequately or provide appropriate coping strategies. The importance of an ‘idioms of distress’ approach to psychiatric evaluation is noted.


Social Support Coping Strategy Adaptive Response Support Network Alternative Mode 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Abbott, John 1932 The Keys of Power. New York: Dutton.Google Scholar
  2. Alland, A. 1970 Adaption in Cultural Evolution: An Approach to Medical Anthropology. New York: Columbia University Press.Google Scholar
  3. American Psychiatric Association 1980 Diagnostic and Statistical Manual of Mental Disorders, Third Edition. Washington, D.C.: American Psychiatric Association.Google Scholar
  4. Barnett, Stephen 1970 The Structural Position of a South Indian Caste. University of Chicago. Ph.D. Dissertation. (unpublished)Google Scholar
  5. Carstairs, G. Morris 1956 Hingra and Aryan: Two Derivatives of Hindu Attitudes to Sexuality. British Journal of Medical Psychology 29: 128–38.Google Scholar
  6. Carstairs, G. Morris and Kapur, R. L. 1976 The Great Universe of Kota: Stress, Change and Mental Disorder in an Indian Village. Berkeley: University of California Press.Google Scholar
  7. Claus, Peter J. 1973 Possession, Protection and Punishment as Attributes of Deities in a South Indian Village. Man in India 53: 3.Google Scholar
  8. Claus, Peter J. 1975 The Siri Myth and Ritual: A Mass Possession Cult of South India. Ethnology 14 (1): 47–58.Google Scholar
  9. Claus, Peter J. 1979 Spirit Possession and Spirit Mediumship From the Perspective of Tulu Oral Traditions. Culture, Medicine and Psychiatry 3: 29–52.Google Scholar
  10. Douglas, Mary 1966 Purity and Danger. New York and Washington: Frederick A. Praeger.Google Scholar
  11. Dumont, Louis 1970 Homo Hierarchicus. Chicago: University of Chicago Press.Google Scholar
  12. Dunn, F. L. 1976 Traditional Asian Medicine and Cosmopolitan Medicine as Adaptive Systems. In Asian Medical Systems, Charles Leslie, (ed.), Berkeley: University of California Press.Google Scholar
  13. Foucault, Michel 1975 The Birth of the Clinic: An Archaeology of Medical Perception. New York: Vintage Books.Google Scholar
  14. Gough, K. 1959 Cults of the Dead Among the Nayar. In Traditional India, Milton Singer, (ed.), Philadelphia: American Folklore Society.Google Scholar
  15. Good, Byron J. and Mary Jo Del Vecchio Good 1980 The Meaning of Symptoms: A Cultural Hermeneutic Model for Clinical Practice. In The Relevance of Social Sciences for Medicine, L. Eisenberg and A. Kleinman, (eds.), Boston: Reidel Pub. Co.Google Scholar
  16. Harper, E. B. 1964 Ritual Pollution as an Integrator of Caste and Reliigon. In Religion in South India; E. B. Harper, (ed.), Seattle: University of Washington Press; pp. 151–96.Google Scholar
  17. Harper, E. B. 1969 Fear and the Status of Women. Southwest Journal of Anthropology 25 (1): 81–95.Google Scholar
  18. Hartmann, H. 1958 Ego Psychology and the Problem of Adaptation. New York: International University Press.Google Scholar
  19. Hartmann, H. 1964 Essays on Ego Psychology. New York: International University Press.Google Scholar
  20. Havens, Leston 1973 Approaches to the Mind. Boston: Little Brown.Google Scholar
  21. Kendall, Laurel 1981 ‘Cold Womb’ (Naeng): Models and Meanings for a Korean Illness Concept. Research report presented to Cultural Research Seminar, Department of Psychiatry, University of Hawaii.Google Scholar
  22. Kleinman, Arthur 1980 Patients and Healers in the Context of Culture. Berkeley: University of California Press.Google Scholar
  23. Kluger, J. M. 1969 Childhood Asthma and the Social Milieu. Journal of the American Academy of Child Psychiatry 8 (2).Google Scholar
  24. Kunstadter, Peter 1978 Do Cultural Differences Make A Difference? Choice Parts in Medical Systems Available in Northwestern Thailand. In Culture and Healing in Asian Societies, A. Kleinman et al., Cambridge, Massachusetts: Schenkman.Google Scholar
  25. Lewis, I. M. 1971 Ecstatic Religion: An Anthropological Study of Spirit Possession and Shamanism. Harmondsworth, Middlesex, England: Penguin.Google Scholar
  26. Marriott, Mckim 1976 Hindu Transactions: Diversity Without Dualism. Philadelphia: Institute for the Study of Human Issues.Google Scholar
  27. Mechanic, David 1964 The Influence of Mothers on Their Children's Health Attitude and Behavior. Pediatrics 33 (3): 4444–53.Google Scholar
  28. Nichter, Mark 1977a Health Ideologies and Medical Cultures of the South Kanara Areca-nut Belt. University of Edinburgh. Ph. D. Thesis. (unpublished)Google Scholar
  29. Nichter, Mark 1977b The Joga and Maya of the Tuluva Būta. Eastern Anthropologist 30 (2): 139–55.Google Scholar
  30. Nichter, Mark 1978 Patterns of Resort in the Use of Therapy Systems and Their Significance for Health Planning in South Asia. Medical Anthropology 2: 29–56.Google Scholar
  31. Nichter, Mark 1981 Negotiation of the Illness Experience: Ayurvedic Therapy and the Psychosocial Dimension of Illness. Culture, Medicine and Psychiatry 5: 1–27.Google Scholar
  32. Obeyesekere, Gananath 1976 The Impact of Ayurvedic Ideas on the Culture and the Individual in Sri Lanka. In Asian Medical Systems: A Comparative Study, Charles Leslie, (ed.), Berkeley: University of California Press.Google Scholar
  33. Obeyesekere, Gananath 1978 Illness, Culture and Meaning: Some Comments on the Nature of Traditional Medicine. In Culture and Healing in Asian Societies, A. Kleinman et al., (eds.), Cambridge, Massachusetts: Schenkman.Google Scholar
  34. Ortner, Sherry 1973 Sherpa Purity. American Anthropologist 75: 49–63.Google Scholar
  35. Porkert, M. 1974 The Theoretical Foundations of Chinese Medicine: Systems of Correspondence. Cambridge, Massachusetts: M.I.T. Press.Google Scholar
  36. Roy, Monisha 1975 Bengali Women. Chicago: University of Chicago Press.Google Scholar
  37. Sich, Dorothea 1979 Encounter with a Folk-Illness During Modern Gynecological Consultations in Korea. Curare: Zeitschrift fur Ethnomedizine und Trans-kulturelle Psychiatrie 2: 87–96. (In German)Google Scholar
  38. Srinivas, M. N. 1962 Caste in Modern India and Other Essays. London: Asia Publishing House.Google Scholar
  39. Weidman, H. and Sussex, James 1971 Cultural Values and Ego Functioning in Relation to the Atypical Culture-Bound Reactive Syndromes. International Journal of Social Psychiatry 17: 83–100.Google Scholar
  40. Zola, I. K. 1966 Culture and Symptoms — An Analysis of Patients Presenting Complaints. American Sociological Review 31 (5).Google Scholar

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© D. Reidel Publishing Co. 1981

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  • Mark Nichter

There are no affiliations available

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