Culture and Panic Disorder

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

7
Dizziness and Panic in China
Organ and Ontological Disequilibrium

Lawrence Park and Devon E. Hinton

IN MANDARIN CHINESE, the term for dizziness is tou yun, literally, “circular motions in the head” (tou, “head”; yun, “circular motion”). Tou yun indicates a variety of physical sensations, including lightheadedness, general instability, head discomfort, syncope, and true vertigo, that is, the sensation of oneself or of the surrounding world spinning. Upon describing themselves as tou you, patients often make circular hand motions near the head.

Dizziness is a common presenting symptom for Chinese patients. Panic is not. Chinese do not typically recount to others, “I am having panic attacks,” but acute episodes of distress resembling Western panic are discernable. In one study of patients with neurasthenia—a common professional and popular illness category in China—35 percent were found to have panic disorder (Kleinman 1982). Panic is experienced in China, but it manifests in locally specific forms.

Distress ontology is influenced by the theoretical models available to individuals to understand their suffering. Kleinman employs the concept of explanatory model to refer to “the notions about an episode of sickness and its treatment that are employed by all those engaged in the clinical process” (1980:105). Such explanatory models often emerge from fundamental principles of a culture (Good 1994); epistemic systems provide the theoretical framework for shaping how individuals explicate, experience, and create meaning from suffering. Two unique systems of medical understanding coexist in contemporary China: biology-based Western medicine and traditional Chinese medicine (TCM). TCM is an indigenous system of medicine, developed empirically over the past four thousand years of Chinese

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