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Outline for an externalist psychiatry (2): an anthropological detour

Ongaro, Giulio (2024) Outline for an externalist psychiatry (2): an anthropological detour. [Preprint]

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Abstract

Philosophical speculation about how psychiatric externalism might work in practice has yet to consider the multitude of actual externalist psychiatric systems that exist outside of modern psychiatry. On the conviction that anthropological insights can inform philosophical debate on the matter, the paper illustrates one such case. The discussion is based on 19 months of first-hand ethnographic fieldwork among Akha, a group of swidden farmers living in highland Laos and neighbouring borderlands. Firstly, the paper describes the Akha set of medicinal, ritual, and shamanic practices, analysing issues of stigma and medical pluralism within it. Secondly, it makes the case that the Akha realise a functioning biopsychosocial system which comes with a well-developed set of resources for treating the social dimension of illness. Externalism among the Akha reframes psychiatric illness as a ‘problem in living’, which becomes manageable as such. The paper claims that, in so doing, the Akha system succeeds in many of the areas where modern internalist psychiatry falls short, and that it does so because Akha society is structured in such a way so that its practitioners can shift the social environment around the patient. As a take-away for philosophers, it suggests that the development of an externalist psychiatry must begin from questioning the accepted ontology of the social causes of psychiatric illness.

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Item Type: Preprint
Creators:
CreatorsEmailORCID
Ongaro, Giuliog.ongaro@lse.ac.uk0000-0003-2782-0642
Keywords: Biopsychosocial model; ethnopsychiatry; stigma; shamanism; medical pluralism; externalist psychiatry
Subjects: Specific Sciences > Anthropology
General Issues > Causation
Specific Sciences > Medicine > Psychiatry
Depositing User: Dr. Giulio Ongaro
Date Deposited: 28 Jan 2024 11:17
Last Modified: 28 Jan 2024 11:17
Item ID: 23018
DOI or Unique Handle: 10.13140/RG.2.2.36652.64644
Subjects: Specific Sciences > Anthropology
General Issues > Causation
Specific Sciences > Medicine > Psychiatry
Date: 25 January 2024
URI: https://philsci-archive.pitt.edu/id/eprint/23018

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