Mental Illness is Different for Different People

Any type of illness can be thought of or taken differently from person to person depending on a variety of different factors such as how old you are, where you live, your family and friends, and experience you’ve had with the illness. In the lecture video “learning about health through ethnography” it talks in the beginning about the doctor patient relationship. Doctors can not always give the same treatment plans for the same diseases to different patients. What works for one person may not be as successful for another person because of the different factors such as age, gender, where your from, etc. As described in the video, explanatory models vary from society to society. Explanatory models have to do with the way different people view and interpret a disease, illness, or issue. In the reading “Conflicting Explanatory Models in the Care of the Chronically Ill” it describes explanatory models as a cognitive map which i found helpful in understanding the term.  In the study about “madness in Zanzibar”, the researcher discusses how the Islamic religion and Muslim culture can play a role in creating an explanatory model for schizophrenia. The belief in spirits can be a cause of madness in their lives and Muslims believe in active spirits as the Quran states they are real. When people feel these spirits are taking a toll on their thoughts it can create anger and violence according to the article. The families that were researched all found different outcomes based on their relationship with the diagnosed family member  and how they treated and thought about the schizophrenia. Explanatory models are used to provide more effective care and treatment for patients. Explanatory models help for a person to understand an illness and if they have one, what their illness is and how to go about handling it, treatment, etc. With an explanatory model a person can discuss with their doctor treatment options and what will benefit them best economically. The patient learns how to communicate with their loved ones about their illness and in turn they can communicate and support the patient. In the example used in the first lecture video the explanatory model that people with Ebola in a foreign country formed was a negative one toward white American doctors.  In a blog article, “The Patient Explanatory Model”, the researcher suggests instead of just asking about the symptoms and forming a diagnosis you should ask questions to learn how the patient sees his or her illness such as “what do you think caused your problem” or  ” what do you think your sickness does to you” (Kandula). Explanatory models are beneficial to people to help them interpret their issues (the how and why) and make them feel more comfortable when dealing with them.

Kandula, Namratha. “The Patient Explanatory Model.” The Health Care Blog. June 11, 2013. Accessed July 13, 2016. http://thehealthcareblog.com/blog/2013/06/11/the-patient-explanatory-model/.

2 thoughts on “Mental Illness is Different for Different People

  1. Hi Kendra, I like that you address the effects of how a family thinks about an illness and how those thoughts and actions can affect the individual with the illness. This is very apparent in the study, Madness in Zanzibar: An Exploration of Lived Experience, when looking at how the three families treated those with schizophrenia. The first two families discussed seemed fairly dismissive of the outbursts and odd actions of the members with the illness and displayed indirectness in disapproval and emotional reserve. However, in the third family, Shazrin, the family member with schizophrenia, was made into the family joke and their treatment of her worsened her symptoms as stated by the author, Juli McGruder (McGruder, 277). This shows how much the environment a person is in can change their illness and how they handle it.

    I agree with you that patients should be asked about more than just their symptoms and should be listened to more closely. I believe Arthur Kleinman addresses this perfectly when he says physicians should return to the way beginning medical students listen to patients “…with great intensity, with something approaching awe in respect for hearing the patient’s story in his or her own words and with deep sympathy for the human condition of suffering” (Kleinman, 130). If physicians listened to the explanatory models of their patients better and incorporated them more into the treatment of diseases, they might be more successful.

  2. Hi Kendra,
    In the beginning of your post, you touched on the importance of the patient-provider relationship. I think this is one of the most important things to address when it comes to explanatory models. When doctors fail to address issues outside of the immediate health issue, it can be very discouraging for the patient. It is important to see the whole picture and to hear all of the patient’s concerns. If he doctor does not, they may miss a big part of the problem or the patient may feel belittled and less likely to seek health care in the future. We saw an example of this in the dialogue between the patient and the doctor in “Conflicting Explanatory Models in the care of the Chronically Ill” (Arthur, 129). The patient goes to see a doctor about a skin condition and the doctor ignores every variable in her personal life and only addresses the physical symptoms of her illness. This patient does not go back to the doctor. Personally, I have had this problem as well. For about a year I was getting sick after eating and I felt miserable all the time. My family has a history of Celiac disease and other sensitivities to foods, so I had an inkling that something I was eating was the problem. I went to several doctors to try and figure out how to fix why I was feeling so horrible all the time and none of them listened to my concerns because the test I had for Celiac had come back negative. Eventually, I found a doctor who listened to my concerns and we found out that I have a gluten sensitivity and I have felt better since adjusting my diet. I think it is very important that doctors make a point to listen to their patients despite their hectic schedules.
    Best,
    Heather

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