Culture and Panic Disorder

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

10
Panic Illness in Tibetan Refugees

Eric Jacobson

AS PART OF A LARGER STUDY of psychiatric aspects of the contemporary practice of classical Tibetan medicine, I conducted interviews with six Tibetan refugees living in an urban area in northern India1 who had been diagnosed with “lifewind illness” (srog rlung gi nad), a chronic affliction widely recognized by both lay Tibetan refugees and the classical physicians, or emchi ('em chi), who treat them.2 In addition to attesting to chronic symptoms of depression and anxiety, four of the six also described episodes of acute panic that had occurred repeatedly over periods of some months. Neither the classical literature of Tibetan medicine nor colloquial Tibetan parlance has a specific term for such attacks. Patients and emchi alike regard them simply as transient intensifications of chronic “life-wind illnesses.” A description of the Tibetan understanding of “life-wind illness” is therefore necessary to appreciate the “semantic network” (Good 1977) in which these episodes of panic occur.

In this chapter, the classical and lay Tibetan theories that apply to “wind illness” and spirit attacks are reviewed first, followed by narrative accounts of two of the four cases in which “life-wind illness” was accompanied by acute panic. The symptomatology and life events cited as having contributed to the onset and aggravation of illness in the four cases are then discussed. Next these data are compared to research on symptomatology and life events in panic disorder (PD) in the United States and Great Britain, and several points of similarity and difference are noted. The chapter closes with a comment on current prospects for the development of a biocultural interactionist view of panic illnesses.

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