Rainforest Asylum

Rainforest Asylum
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Описание книги

Malaysian psychiatric services and policy show some similar developments to those of the West. Yet much of the rhetoric that has informed these changes internationally have yet to be fully embraced in a modern, industrialised nation seeking to develop services congruent with the complex and rich diversity of ethnicity, culture and geography in the region.
The relevance of this unique and extensive ethnographic study is that it captures the fascinating and otherwise lost voices of Malaysian service users, in a cultural context where a scientific, positivistic discourse prevails.
However, its aims are more far reaching in that while providing an account that straddles the fault lines of both medical sociology and medical anthropology, it also critically engages with intriguing historiographic accounts of imperial and colonial psychiatry. These serve to illuminate the ideologies and practices underpinning the colonial psychiatric mission across the nineteenth century in Asia and Africa, and which today hold identifiable influences, both for good and ill, in contemporary psychiatric services in post-colonial nations, such as Malaysia. As such this book will appeal not only to social scientists but also to mental health professions working with a culturally diverse client base.

Оглавление

Sara Ashencaen Crabtree. Rainforest Asylum

A Rainforest Asylum

Contents

Preface

Acknowledgements

1. Introduction

A guide to terms and semantics

The social and historical background to the study

Organisation and navigation

2. Fieldwork and field relationships

The research process

Gatekeepers and participants

Field notes. Male Ward 1:

Field notes. Female Ward 2:

Planning the research campaign

Language and meaning

Ethics and fieldwork

3. Psychiatry and the colonial enterprise in historical Malaya and Borneo. The historical context in Europe

Complicit psychiatry

Colonial psychiatry and anthropology

Madness and gender in multicultural Malaya

Borneo: Disease, disasters, colonial rule and colonial medicine

The demise of the ‘therapeutic’ asylum in pre and post-war Malaya

Notes

4. The transformation to patient-hood

Categorising patients: The ‘salvageable’ and the ‘irredeemable’

Field notes: Female Ward 2

Field notes: Male Ward 3

The cycle of patient-hood through admission and discharge

Field notes: Female Ward 1

Ward life and the process of socialisation

Field notes: Male Ward 1

Field Notes: Female Ward 1

Field notes: Female Ward 1

Note

5. Ward relationships: Power and reciprocation

Reciprocal relationships

Field notes. Male Ward 1

Dominant relationships

Field notes. Female Ward 2

Field notes. Male Ward 1

Familial relationships and patient labour

Field notes. Female Ward 2

Note

6. Healing, medication and resistance

Field notes. Female Ward 1

Field notes. Male Ward 1

Healing and spirituality

ECT as an instrument of control

Field notes. Female Ward 1

Field notes. Male Ward 1

7. Mad, wanton women and the feminine ideal

‘Open’ and closed wards

Field notes. Locked section, Male Ward 1

Field notes. Female Ward 1

Field notes. Female Ward 1

Gender and recreation

Field notes. Female Ward 2

The lesbian alternative

8. Strategies of containment on the ward

Moral containment of patients and ethnic typecasting

Physical containment of the debased

Fear of the oppressed: Staff accounts of the locked wards

Cunning and deceit: The essentialised patient

Violence towards female staff

9. Towards community psychiatry

Dissent in the ranks

Community psychiatry and coal-face staff

Field notes. Male Ward 1

Field notes. Male Ward 2

Making a difference? Social work and counselling

The views of medical officers

10. Reflections and conclusions

The enduring nature of the asylum

References

Index

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A Rainforest Asylum:

The enduring legacy of colonial psychiatric care in Malaysia

.....

Contact with staff provided a fascinating contrast, in that, as stated, while female nursing staff were often reticent, their male counterparts - the ‘medical assistants’ - on the male wards were much more willing to disclose information to me than the female nursing staff and could be, when they chose to be, cheerful, amusing and friendly in their interactions with me. Such was the peculiar and intriguing balance in that in general women patients and male nursing staff were by far the most helpful and friendly towards me, whilst male patients and female nursing staff were often distant, close-lipped and occasionally overtly suspicious of me. As others have noted, women as researchers are seen as more harmless (and usually less socially important) than male researchers by male participants and therefore as less likely to use information in a damaging way (Gurney, 1991; Warren, 1988).

Any perceived lack of status on the grounds of gender may therefore have worked against forming a good rapport with female staff, in that there were few incentives for them to overcome the insider/outsider power dichotomy in an environment of closed ranks. Furthermore, Taylor (1991) points out that in his own research in a male-dominated setting rapport with informants was built upon a foundation of male solidarity, socialising activities and initiation ceremonies, something from which I was culturally barred in my own research with men and which did not materialise with women members of staff. Yet a few friendships were developed between myself and female members of staff, where one nurse occasionally pressed on me bottles of homemade tuak (rice wine), which at first I thought I was expected to pay for and only later realised were spontaneous gifts.

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