Culture and Panic Disorder

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

3
A Medical Anthropology of Panic Sensations
Ten Analytic Perspectives

Devon E. Hinton and Byron J. Good

THIS CHAPTER PROVIDES an analysis of panic and panic disorder from the perspective of a medical anthropology of sensations. Our overall argument is that sensation is not precultural but is very much embedded in culture. It follows that crosscultural analysis of panic experiences and panic disorder, dependent as they are on the experience and interpretation of particular sensations, requires an explicit framework for the analysis of sensation. In the following pages we outline such a framework and illustrate its utility for understanding panic and panic disorder from a cultural perspective.

We use the term sensation to indicate a variety of somatic forms of experience, from feelings of heat in the body to dizziness to palpitations. The terms sensation1 and somatic symptom are often interchangeable; the former, however, emphasizes sensory experience, an emerging bodily experience, while the latter emphasizes the medical interpretation of sensation, the somatic event as a symptom of a certain “disorder.” In a panic attack, certain sensations give rise to fearful cognitions. Often a sufferer focuses on—and gives as the presenting complaint to a clinician—a single sensation that occurs in a panic attack, selected from among many sensations felt during the episode. Because somatic experiencing forms a core aspect of panic attacks, a complex understanding of sensations is needed to analyze these attacks adequately.2

To research sensation experience, we suggest ten analytic perspectives. Investigating sensation through such a framework prevents the committing of a certain kind of category error (Kleinman 1988)—the naive assumption that an illness or symptom in our society has exact equivalents in other societies, that the problem

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