Understanding Explanatory Models

In American and European culture we believe that mental illness can be explained in biological terms. Here we understand the scientific reasons behind mental illness. For example, a lack of serotonin can cause depression, anxiety, and even insomnia. However after reading “Madness in Zanzibar” (McGruder) I was able to see the cultural explanatory model that was formed. They explained that mental illness was caused by spirits. In their language they had words such as nafsi, moyo, and roho which described the id, and ego. In their culture they believed that Allah was testing them and eventually things would get better.  I was pleasantly surprised by the way that Kimwana’s family was supportive of her illness. The families of Kimwana and Khadija did seem to understand that these were diseases that required biological treatment as well. Kimwana’s family were willing to give her space when needed and didn’t overwhelm her. This was a similar case regarding Khadija and Yusuf. The families were supportive and understanding of their ill family members. When it came to Shazrin’s family I was frustrated reading about how she was mocked and Abdulridha controlled every aspect of her life. Her family disciplined her and was didn’t seem to have a good understanding of Shazrin’s illness. I noticed that most of the families I read about were able to include both cultural and biological health treatments for mental illness. Even though Shazrin’s family viewed her as a burden, with her family used an herbal scalp treatment to “cool her mind.” Also Shazrin was prescribed Fluphenazine and taken to the hospital many times.  As you can see the families in Zanzibar believe in cultural and biological influences which is why both are used in the treatment of mental disorders.  As for the health outcomes I think it is beneficial to have a mix of both biological and cultural outcomes. It can be harder to treat some individuals who believe only in a more cultural explanatory model. Many individuals from Western African countries, Bangladesh, and the Caribbean follow a cultural explanatory model. They are also  somewhat resistant to get medical treatment(McCabe 2004). Health outcomes are greatly affected by whether a person has an understanding of what is actually happening to them so they can get proper medical treatment. If a person’s explanatory model is only cultural and they don’t receive proper medical treatment it could have a devastating effect . In the US we have a biological explanatory model but, often people here view mental illness as a horrible disease and associate some stigma with it. From a personal point I have two family members with schizophrenia and unfortunately after many attempts to include them into our family they are not. My family has a strong belief in biological explanatory models since many of my family members are doctors. However, there are still members of our family  that look down on my mentally ill family members and definitely associate a stigma with them, which is unfair. Overall we might be a technologically advanced country but, we could definitely lose the stigma around mental illness and learn something from the families in Zanzibar.

Mccabe, R. “Explanatory Models of Illness in Schizophrenia: Comparison of Four Ethnic Groups.” The British Journal of Psychiatry 185, no. 1 (2004): 25-30. Accessed July 15, 2016. doi:10.1192/bjp.185.1.25.


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