Skip to main content

Advertisement

Log in

Family Expressed Emotion in a Javanese Cultural Context

  • Original Paper
  • Published:
Culture, Medicine, and Psychiatry Aims and scope Submit manuscript

Abstract

This study aims at understanding the emotional milieu of families of psychotic patients, focusing on the concept of expressed emotion (EE). A combination of ethnographic and clinical methodology was employed. During the fieldwork in Yogyakarta, Indonesia, nine participants diagnosed as having first episode psychosis and their families were followed closely over the course of 1 year in their natural home setting. Through ongoing engagement with families, the researcher was able to gather data on the diversity of family responses to illness. Despite the fact that most families in this research could be considered to have low EE, ethnographic observation provided a more complex and nuanced picture of family relationships. This article discusses four issues concerning EE in relation to Javanese culture: the role of interpretation, the coexistence of criticism and warmth, the interpretation of boundary transgression, and the cultural concept of warmth and positive remark.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Notes

  1. Lebaran is the Javanese annual festival conducted after 1 month’s fasting during the month on Ramadan. It is also known as bodo.

  2. Some part of this section has been translated into Indonesian and published in Subandi (2008).

References

  • Bachmann, S., Bottmer, C., Jacob, S., & Schröder, J. 2006. Perceived Criticism in Schizophrenia: A Comparison of Instruments for the Assessment of the Patient’s Perspective and Its Relation to Relatives’ Expressed Emotion. Psychiatry Research, 142, 167-175.

    Article  Google Scholar 

  • Bateson, G., Jackson, D. D., & Haley, J. 1963. A Note on the Double Bind. Family Process, 2, 154-161.

    Article  Google Scholar 

  • Bhugra, D., & McKenzie, K. 2003 Expressed Emotion Across Cultures. Advances in Psychiatric Treatment 9: 342–348.

  • Brown, G. W. 1985. The Discovery of Expressed Emotion: Induction or Deduction? In J. Leff & C. Vaughn (Eds.), Expressed Emotion in Families (pp. 7-25). New York: Guilford Press.

    Google Scholar 

  • Brown, G. W. & Rutter, M. 1966. The Measurement of Family Activities and Relationships: Methodological Study. Human Relations, 19, 241-263.

    Article  Google Scholar 

  • Butzlaff, R. L., & Hooley, J. M. 1998. Expressed Emotion and Psychiatric Relapse: A Meta-analysis. Archives of General Psychiatry, 55, 547-552.

    Article  Google Scholar 

  • Cole, J.D. & Kazarian, S.S. 1988. The Level of Expressed Emotion Scale: A New Measure of Expressed Emotion. Journal of Clinical Psychology . 44(3):392-7.

    Article  Google Scholar 

  • Falloon, I. R. H., Boyd, J. L., & McGill, C. W. 1984. Family Care of Schizophrenia: A Problem-Solving Approach to the Treatment of Mental Illness. New York: Guilford Press.

    Google Scholar 

  • Geertz, H. 1961. The Javanese Family: A Study of Kinship and Socialization. New York: The Free Press of Glencoe.

    Google Scholar 

  • Gerlsma, C., & Hale, W. 1997. Predictive Power and Construct Validity of the Level of Expressed Emotion (LEE) Scale: Depressed Out-Patients and Couples from the General Community. British Journal of Psychiatry, 170, 520-525.

    Article  Google Scholar 

  • Good, B. J., and M. A. Subandi 2000 A Study of First Episode/First Contact Psychosis in Special Region Yogyakarta Province, Indonesia. Preliminary Research Report.

  • Good, B.J. & Subandi, M.A. 2004. Experiences of Psychosis in Javanese Culture: Reflections on a Case of Acute, Recurrent Psychosis in Contemporary Yogyakarta, Indonesia. In J. Jenkins and R. J. Barrett (eds). The Edge of Experience: Culture, Subjectivity and Schizophrenia. Cambridge: Cambridge University Press.

    Google Scholar 

  • Good, B.J., Good, M.D. & Subandi, M.A. 2007. The Subject of Mental Illness: Psychosis, Mad Violence and Subjectivity in Indonesia. In Subjectivity: Ethnographic Investigations. Joao Biehl, Byron Good, and Arthur Kleinman (pp. 243–272) eds. Berkeley: University of California Press.

    Google Scholar 

  • Good, B. J., Marchira, C., Hasanat, N. U., Utami, M. S., & Subandi, M. A. 2010. “Is ‘Chronicity’ Inevitable for Psychotic Illness? Studying Heterogeneity in the Course of Schizophrenia in Yogyakarta, Indonesia,” in Lenore Manderson and Caroline Morris (pp. 54–76) (eds). Chronic Conditions, Fluid States. New Brunswick, NJ: Rutgers University Press.

    Google Scholar 

  • Hashemi, A. H., & Cochrane, R. 1999. Expressed Emotion and Schizophrenia: A Review of Studies Across Cultures. International Review of Psychiatry, 11: 219-224.

    Article  Google Scholar 

  • Jenkins, J. H. 1991. Anthropology, Expressed Emotion, and Schizophrenia. Ethos. 19(4), 387-431.

    Article  Google Scholar 

  • Jenkins, J. H., & Karno, M. 1992. The Meaning of Expressed Emotion: Theoretical Issues Raised by Cross-Cultural Research. American Journal of Psychiatry, 149(1), 9-20.

    Google Scholar 

  • Jenkins, J. H., Karno, M., de la Silva, A., & Santana, F. 1986. Expressed Emotion in Cross-Cultural Context: Familial Responses to Schizophrenia Illness Among Mexican American. In M.J. Goldstein, I. Hand, & K. Halberg. Treatment of Schizophrenics: Family Assessment and Intervention (pp. 35-49). New York: Spring Verlag.

    Google Scholar 

  • Kamal, A. 1995. Variable in Expressed Emotion Associated with Relapse: A Comparison Between Depressed and Schizophrenic Samples in an Egyptian Community. Current Psychiatry, 2(2), 211-216.

    Google Scholar 

  • Karno, M., Jenkins, J. H., de la Selva, A., Santana, F., et al. 1987. Expressed Emotion and Schizophrenic Outcome Among Mexican-American Families. Journal of Nervous and Mental Disease, 175(3), 143-151.

    Article  Google Scholar 

  • Keeler, W. 1987. Javanese Shadow Plays, Javanese Selves. Princeton, NJ: Princeton University Press.

    Google Scholar 

  • Kuipers, E. 1992. Expressed Emotion in 1991. Social Psychiatry and Psychiatric Epidemiology, 27 (1-3).

    Article  Google Scholar 

  • Leff, J. & Vaughn, C. 1985. Expressed Emotion in Families. New York: The Guilford Press.

    Google Scholar 

  • Leff, J., Wig, N. N., Ghosh, A., Bedi, H., Menon, D. K., Kuipers, L., Korten, A., Ernberg, G., Day, R., & Sartorius, N. 1987. Expressed Emotion and Schizophrenia in North India. III: Influence of Relatives’ Expressed Emotion on the Course of schizophrenia in Chandigarh. British Journal of Psychiatry, 151, 166-173.

    Article  Google Scholar 

  • Lidz, T., Cornelison, A. R., Fleck, S., & Terry, D. 1960. Schism and Skew in the Families of Schizophrenics. In N. W. Bell & E. F. Vogel (Eds.), A Modern Introduction to the Family (pp. 595-607). London: Roudledge & Kegan Paul.

    Google Scholar 

  • Magana, A.B., Goldstein, M.J., Karno, M., Miklowitz, D.J., Jenkins, J., & Falloon, I.R.H. 1985. A Brief Method for Assessing Expressed Emotion in Relatives of Psychiatric Patients. Psychiatry Research 17, 203–212.

    Article  Google Scholar 

  • Martins, C., Lemos, A. I., & Bebbington, P. E. 1992. A Portuguese/Brazilian Study of Expressed Emotion. Social Psychiatry and Psychiatric Epidemiology, 27, 22-27.

    Article  Google Scholar 

  • McGruder, J. H. 2004. Madness in Zanzibar: An Exploration of Lived Experience. In J. H. Jenkins & R. J. Barrett (Eds.), Schizophrenia, Culture, and Subjectivity: The Edge of Experience, (pp. 255-281). Cambridge: Cambridge University Press.

    Google Scholar 

  • Mottaghipour, Y., Pourmand, D., Maleki, H., & Davidian, L. 2001. Expressed Emotion and the Course of Schizophrenia in Iran. Social Psychiatry and Psychiatric Epidemiology, 36(4), 195-199.

    Article  Google Scholar 

  • Mulder, N. 1994. Individual and Society in Java: A Cultural Analysis. Yogyakarta: Gadjah Mada University Press.

    Google Scholar 

  • Phillips, M. R. & Xiong, W. 1995. Expressed Emotion in Mainland China: Chinese Families with Schizophrenic Patients. International Journal of Mental Health, 24, 54-75.

    Google Scholar 

  • Sacks, J. M. & Levy, S. 1959. The Sentence Completion Test. In Lawrence Edwin Abt & Leopold Bellak (Eds.), Projective Psychology: Clinical Approaches to the Total Personality, (pp. 357–402). New York: Grove Press, Inc.

    Google Scholar 

  • Shiraisi, S. S. 1997. Young Heroes: The Indonesian Family in Politics. Ithaca, NY: Southeast Asia Program Publications, Cornell University.

    Google Scholar 

  • Subandi, M.A. 2006 Psychocultural Dimensions of Recovery from Early Psychosis in Java. Unpublished PhD Dissertation. Adelaide: University of Adelaide, Australia.

  • Subandi, M.A. 2008. Ngemong: Dimensi Keluarga Pasien Psikotik di Jawa (Ngemong: Family Dimension of Psychotic Patients in Java). Jurnal Psikologi. 35(1):62-79.

    Google Scholar 

  • Uehara, T., Yokoyama, T., Goto, M., Kohmura, N., Nakano, Y., Toyooka, K., & Ihda, S. 1997. Expressed Emotion from the Five-Minute Speech Sample and Relapse of Out-patients with Schizophrenia. Acta Psychiatrica Scandinavica. 95:454–456.

    Article  Google Scholar 

  • Van Humbeeck G., Van Audenhove, Ch., De Hert, M., Pieters, G., Storms, G. 2002. Expressed Emotion: A Review of Assessment Instruments. Clinical Psychology Review. 22(3):323-43.

    Google Scholar 

  • Wig, N. N., Menon, D. K., Bedi, H., Leff, J., Kuipers, A., Ghosh, R., Day, A., Korten, G., Ernberg, N., Sartorius, N., Jablenski, A. 1987. Expressed Emotion and Schizophrenia in North India II: Distribution of Expressed Emotion Components Among Relatives of Schizophrenic Patients in Aarhus and Chandigarh. British Journal of Psychiatry, 151, 160-165.

    Article  Google Scholar 

  • Wynne, L.C., Ryckoff, I.M., Day, J., & Hirsch, S.I. 1960. Pseudo Mutuality in the Family Relations of Schizophrenics. In N. W. Bell & E. F. Vogel (Eds.), A Modern Introduction to the Family (pp. 573-594). London: Routledge & Kegan Paul.

    Google Scholar 

  • Zaumseil, M., & Lessmann, H. 1995 Dealing with Schizophrenia in Central Java. http://www.fu-berlin.de/psychologie/klinische/java_99.pdf. Accessed 12 May 2007.

Download references

Acknowledgments

My sincere thanks go to all participants and their family members involved in this research who allowed me to come to their houses and shared their experiences. I wish to thank to Professor Robert J. Barrett (Department of Psychiatry, University of Adelaide), Dr. Rodney Lucas (Department of Anthropology, University of Adelaide), and Professor Byron J. Good (Department of Social Medicine and Global Health, Harvard University) for their supervision of my dissertation from which this article is based.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. A. Subandi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Subandi, M.A. Family Expressed Emotion in a Javanese Cultural Context. Cult Med Psychiatry 35, 331–346 (2011). https://doi.org/10.1007/s11013-011-9220-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11013-011-9220-4

Keywords

Navigation