Culture, Medicine, and Psychiatry

, Volume 34, Issue 2, pp 279–300

Llaki and Ñakary: Idioms of Distress and Suffering Among the Highland Quechua in the Peruvian Andes

Original Paper

DOI: 10.1007/s11013-010-9173-z

Cite this article as:
Pedersen, D., Kienzler, H. & Gamarra, J. Cult Med Psychiatry (2010) 34: 279. doi:10.1007/s11013-010-9173-z


This article examines some of the long-term health outcomes of extreme adversities and the ways in which social inequalities and idioms of distress are historically and socially produced in the Peruvian context. We describe how the highland Quechua of northern Ayacucho construct and experience expressions of distress and suffering such as pinsamientuwan (worrying thoughts, worries), ñakary (suffering) and llaki (sorrow, sadness), in a context of persistent social inequalities, social exclusion and a recent history of political violence. It is concluded that the multiple expressions of distress and suffering are closely related to past and current events, shaped by beliefs, core values and cultural norms and, in this process, transformed, recreated and invested with new meanings and attributions.


Idioms of distress Social suffering Violence Social inequality Mental illness Highland Quechua Peru 

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Duncan Pedersen
    • 1
  • Hanna Kienzler
    • 2
  • Jeffrey Gamarra
    • 3
  1. 1.Douglas Institute Research Centre and Division of Social and Transcultural Psychiatry, Department of PsychiatryMcGill UniversityMontrealCanada
  2. 2.Department of AnthropologyMcGill UniversityMontrealCanada
  3. 3.Departamento de Humanidades y Ciencias SocialesUniversidad Nacional San Cristóbal de HuamangaAyacuchoPeru

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