Culture and Panic Disorder

By Devon E. Hinton; Byron J. Good | Go to book overview

2
Theoretical Perspectives on the
Cross-Cultural Study of Panic Disorder

Laurence J. Kirmayer and Caminee Blake

IN RECENT PSYCHIATRIC LITERATURE, panic disorder is usually portrayed as a biologically based disorder resulting from the hypersensitivity of brain systems involved in the anxious response to specific types of threat—especially to the threat of separation from loved ones or to choking or suffocation. At the same time, it is clear from clinical and experimental work that catastrophic cognitions play a crucial role in the genesis and recurrence of panic. Because our thoughts about catastrophe reflect cultural models and concerns, panic disorder provides an interesting opportunity to explore the interaction of bodily and social processes in the cultural shaping of distress.

In this chapter, we explore some ways in which culture may contribute to the pathogenesis, symptomatology, course, and treatment outcome of panic attacks. As with other forms of distress, social interactional processes can contribute to the onset as well as to the recurrence and chronicity of panic. Detailing these interactions involves consideration of both psychosomatic and sociosomatic processes. At the same time, culture provides the larger matrix of knowledge and practice in which our understandings of panic as disorder are framed. Hence, we also consider the issue of the cultural construction of panic in folk psychology and professional nosology. Finally, we explore the role of panic in a larger moral and political economy that identifies regions of the wild, the intolerable, and the “out of control.”

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