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- Convenor:
-
Junko Iida
(Kawasaki University of Medical Welfare)
- Discussants:
-
Melissa Park
(University of California, Los Angeles)
Komatra Chuengsatiansup (Sirindhorn Anthropology Center)
- Location:
- 101a
- Start time:
- 15 May, 2014 at
Time zone: Asia/Tokyo
- Session slots:
- 3
Short Abstract:
This panel explores the sensory experience of suffering and healing, including bodily experience which transcends the five senses. It will embed these experiences with the particular social complexities and dynamics of both biomedicines and traditional medicines in Asia and Europe.
Long Abstract:
Mediating the relationship between self and society, mind and body, idea and object, the senses have been a particular focus in anthropology in the last two decades. The senses are of special interest to medical anthropologists who address suffering and healing as bodily and social experiences. However, much of this research has taken place in the field of non-Western medicine and as a result there lacks sufficient study on the subject in the field of biomedicine. Moreover, the experience of suffering and healing cannot be fully explained in terms of the five senses. This panel thus explores the sensory experience of suffering and healing, including bodily experience which transcends the five senses. It embeds these experiences with the particular social complexities and dynamics of both biomedicines and traditional medicines in Asia and Europe.
Accepted papers:
Session 1Paper short abstract:
This paper examines Filipino ESRD patients' narratives and illustrates the important role of affectivity in mediating between sensations and stories or connecting the sensory and narrative dimensions of suffering.
Paper long abstract:
The illness experience of patients diagnosed with the end-stage renal disease (ESRD) have a peculiar nature. The kidneys, the very organs on which their disease is localized, are conspicuously "absent" in their sensory dimension of the illness experiences. A the same time, the disease "manifests" in a wide array of somatic distresses, such as itch and fatigue, affecting all around the body. In the Philippines where I conducted my fieldwork, ESRD patients receive only the insufficient dose of dialysis. Accordingly, they are often in a poor health condition and suffer agonizing bodily distresses. In this paper, I examine Filipino ESRD patients' narratives of suffering and illustrate the significant role of affectivity in mediating between "sensations" and "stories," or connecting the "sensory" and "narrative" dimensions of suffering. I argue that a tendency to separate the lived experience of illness into the somatic and the mental components and still limits ways we conceive the sensory experience and that, in order for us to overcome the Cartesian dualism, it is crucial to consider the sensory experience as the "bodily affection" as well as the affective feeling as the "embodied feeling."
Paper short abstract:
The paper explores the sensory experience of voice hearing in Finland and control of it through the use of biomedical interventions and cognitive therapy. What does control of the auditory sense tells us about its cultural valuation and the role of biomedicine in shaping unwanted hearing?
Paper long abstract:
This paper explores the sensory experience of voice hearing and is based on ethnographic fieldwork conducted through Moniääniset, an association of voice hearers in Finland. On a global scale a vast number of people (2-4%) regularly experience auditory hallucinations (hearing voices others do not hear). This altered state of mind transforms the self and brings about a great deal of suffering and self-isolation. Auditory hallucinations are hard to categorise in the realm of the sensorium because of the multi-sited nature of where voice hearers perceive them to originate; both within the skin-bound body and extending beyond it. In some cases experiences can also be multi-sensory, further complicating categorisation of these experiences. Biomedical interventions, mostly in the form of psychopharmacology, are employed to numb or remove these disturbing sensory experiences. The use of medication is ambiguous for those who suffer from auditory hallucinations - it is both a desired and un-wanted manner of altering the mind. Alternative therapeutic methods, in the form of cognitive therapy employed to make voice hearers confront and familiarise themselves with their voices, is promoted by Moniääniset. Acknowledging these voices as part of the self and working with them is an emancipatory process, but is also a manner of recognising the fragility of the human mind, the boundary crossing capabilities of the auditory sense and the human capacity to heal the mind. The paper ponders what control of the auditory sense tells us about the cultural valuation of this sense and the role of biomedicine in shaping unwanted hearing in Finnish society.
Paper short abstract:
Patients with low ADL level in palliative care can ward sometimes fall on the way to the toilet. The fact shows that ADL is closely related not only to QOL but to what we may call human dignity. They receive rehabilitation to not lose fundamental perceptions such as walking and discharging.
Paper long abstract:
By defining palliative care as "an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness," WHO remarks that this care is "applicable early in the course of illness." In Japan, however, most of palliative care wards have been similar to a hospice, an institution where patients, for whom biomedicine offers no definite remedy, lead a peaceful life and then die calmly. The palliative care ward in Tokyo where I have carried out anthropological fieldwork is no exception.
As indicated above, the quality of life (QOL) is a significant index in palliative care. There is another important index employed there: activities of daily living (ADL). ADL refers to daily activities which people do without assistance such as eating, dressing, bowel and bladder management, bathing, walking and so forth. Several types of medical staff are working in palliative care ward and physical therapists are one of them. They rehabilitate those who are close to death. The reader might be puzzled why patients in palliative care ward need rehabilitation since these patients will likely die soon.
Patients with low ADL level in palliative care ward sometimes fall down on the way to toilet. The fact that they try to go by themselves facing the risk of a fall clearly shows that ADL is closely related not only to QOL but to what we may call "human dignity."
They receive rehabilitation to not lose fundamental perceptions such as walking and discharging.
Paper short abstract:
By combining field data and Merleau-Ponty's phenomenology, this study examines the mode of perception in East Asian medicine, centered on bodily experience.
Paper long abstract:
How do East Asian medical practitioners diagnose various diseases, solely relying on their own bodies? If biomedical doctors refer to objectified concreteness, such as radiology images, what do traditional practitioners rely on? Why are disease names in East Asian medicine elusive, compared to those in biomedicine? If biomedical disease names designate bodily spaces of affliction, such as liver cancer, why does East Asian medicine tend not to use the spatial fixing? Drawing on three years of fieldwork at Korean medicine clinics in South Korea, this study ethnographically responds to these questions. While the objectification-oriented perception has greatly contributed to biomedicine in this era of cutting-edge diagnostic tools, phenomenological perception shapes the effectiveness of East Asian medicine. By looking at face colors and taking pulses, practitioners of East Asian medicine experience the ways patients experience illness. This "experience of experience" enables practitioners to identify how patients suffer from illnesses at any moment in time, without relying on objectifiable entities. Through long-term "experience of experience," a novice becomes an experienced practitioner, setting up medical "intentionality" that links the practitioner's subject and patients' experience. The elusiveness of East Asian medical terms allows practitioners to employ their own definitions of how a patient suffers at a given time. By combining field data and Merleau-Ponty's phenomenology, this study examines the mode of perception in East Asian medicine, centered on bodily experience.
Paper short abstract:
Pulse touching is a shared bodily experience of suffering and healing between doctor and patient. Through an ethnographic investigation, this paper demonstrates the meaning of pulse touching as an "embodied perceptiveness" and its clinical implications.
Paper long abstract:
Pulse touching is one of the four diagnostic methods of Korean medicine, and is the most susceptive experience among them. Pulse touching is conducted as part of a sensitive and intimate doctor-patient relationship. It is not merely the physical contact between a doctor's fingertips and a patient's wrist, but rather a shared bodily experience that transcends the restricted boundaries of individuals and their spatiotemporal conditions.
Patients' sensory experiences, such as pain, are expressed through bodily responses including their pulses. To trace a patient's bodily manifestation of qi and blood through sensation on fingertips, a Korean medical doctor collectively applies styles of knowledge on pulse touching, such as concepts and perceptions of pulse images and embodied experiences of pulse, all of which, as a whole, enable the practitioner to investigate the links between pulse and a patient's symptoms. Pulse touching provides doctors with a method for feeling patients' suffering in a more diachronic and direct way.
While biomedicine tends to discard suffering that cannot be transferred into numerical values, Korean medicine takes a closer look at patient suffering by diagnosing and treating sensation itself. Through an ethnographic investigation of cases in clinical settings of contemporary Korean medicine, this paper explores the bodily experience of suffering and healing shared between doctor and patient by means of pulse touching, and thus demonstrates the meaning of pulse touching as an "embodied perceptiveness" and its clinical implications.
Paper short abstract:
Drawing on four years-long research with a group of music therapists, this paper explores the sensorial implications of an intervention project in pediatric departments, right before the time of sleep. Ecological, historical and social analysis of an ephemeral sensory-cultural phenomenon.
Paper long abstract:
Drawing on four years-long research with a group of music therapists, this paper explores the sensorial implications of an intervention project in pediatric departments, right before the time of sleep.
Ecological, historical and social coordinates are made explicit: whom does the intervention involve? Which sensoria does Music Therapy involve, especially from a medical anthropological perspective? Where does the radical otherness of music therapists' practices lay, as compared to the everyday nature of the hospital room? Finally, anthropological analysis of 'the embodied' and 'the nonverbal' sheds light over an ephemeral sensory-cultural phenomenon: a non-biomedical action, exquisitely "oral", scientifically almost meaningless, running across the otherwise silent corridors of a medical institution.
But where does communication base, in Music Therapy? And how its aesthetics turns into an epistemological-therapeutic ideology? Does that happen because the healing device consists of a delicate, subtle chime sound, or a mysterious singing, gently approaching? Or is it so for the patient laying in the bed is a child? And what if the ones who fall asleep will be the parents, attending in angst at their child's sickbed?
By exploring the sensory and bodily experience of suffering children and musical healers, the paper aims at contributing to the anthropological understanding of the medicalization of healing. As the sounding movements of music therapists speak to representations about 'mind' and 'body', the refreshing restoration of their lullabies witnesses of a peculiar way of framing the relationship between (a sick) Self and (a care-providing) society.
Paper short abstract:
This paper explores the sensory experience of suffering and caring in palliative care in Japan. It demonstrates how various actors try to create the environment and circumstances of care so as to stimulate divergent aspects of the senses of patients and their families.
Paper long abstract:
There is a lack of anthropological research on the bodily experience of suffering, of healing and of the interactions amongst the patients and caregivers of palliative care, especially in Japan, because of the difficulty of ethnographic fieldwork in this sensitive field. To fill this gap, this paper explores the sensory experience of suffering and caring in palliative care in Japan. Fieldwork has been conducted within the network of palliative care. This network includes patients and their families, staff, and volunteers at a hospital which provides care at home as well as in 19 bed ward for cancer patients and others suffering from a wide range of illnesses. The caring practices of nurses, care workers, physiotherapists and occupational therapists involve the most direct physical contact with patients. Their direct interactions also produce close and strong psychological connections between patients and those practicing these occupations. The interactions between volunteers and patients are more indirect, although they are no less important. The volunteers arrange, plant and tend flowers so patients can enjoy the season. They provide coffee in the lounge to produce a situation in which patients and their families feel relaxed and communicate with other patients, families, staff, and volunteers. Patients often express their feeling in haiku and etegami (picture letters) they write with volunteers and other patients. I will demonstrate how various actors try to craft the environment and circumstances of care in different ways so as to stimulate divergent aspects of the senses of patients and their families.
Paper short abstract:
This paper identifies the sensory recognition of ageing and counter-ageing as the narrowing and expanding of bodily pathways among the elderly Japanese in Kuala Lumpur, Malaysia. It embeds their bodily metaphors within the aesthetic and spiritual cosmology of Japanese traditional art practice of do (way).
Paper long abstract:
Migration to Southeast Asia has become a retirement option for some Japanese elderly in recent years. The Japanese are one of the highest foreign retiree populations in Malaysia. Many Japanese retirees in Malaysia take Japanese traditional art and choir lessons offered by the local Japanese associations. This paper will study the bodily experience of ageing and counter-ageing among the elderly Japanese traditional art practitioners in Kuala Lumpur. Their experience of ageing transcends the five senses. On the one hand, they describe it as a narrowing of their bodily pathways; such as speech impediment, the contraction of blood veins, and suffocation. On the other hand, migrating to Kuala Lumpur is experienced as an expansion in their bodily pathways and thus an attainment of new physical feats in old age. How might their bodily sensations relate to their social relationships and their life trajectory? And how does participation in traditional art practices influence individual anatomy and healing? To decipher the meaning of the bodily pathways that contract and expand, this paper will link the bodily metaphor of pathway with aesthetic and religious metaphor of Do. Do, literally translated as 'pathway', is embedded in traditional art practices in Japan. This paper argues that the bodily ways and aesthetic and religious ways are lived dimensions of a single experience. Participations in traditional art, and consequently, expansions in one's spiritual pathways are experienced as expansions in one's bodily pathways. This gives rise to a better sense of well-being and meaningfulness in later-life.
Paper short abstract:
This paper aims to analyze neo-shamanic rituals developed for Europeans in search of new forms of spirituality. In this context I have observed the role of body and crisis as the point of convergence between contemporary neo-shamanic practices and the contingent world of participants.
Paper long abstract:
During the last four years I have been involved in participant observation in practices held by European and Mexican neo-shamans whose offer is addressed to Europeans. These practices concern the use of shamanic knowledge to reconnect people with a "lost" state of nature, and healing personal and universal troubles. The concept of Shamanism in this context becomes a synonym of "ancestral" and "original" cosmologies.
Neo-shamanic rituals are based upon acting that creatively works out religions, philosophic traditions, fictitious ethnicisms and exotic imageries with the purpose of weaving bonds amongst participants.
I often witnessed during these neo-shamanic activities (seminars, stages, pilgrimages) the creation of small and ephemeral communities sharing the same time and space, which give life to a whole of close, and egalitarian relationships where people drop masks used during daily life and reveal themselves.
In such environment, I observed participants taking actively part in the rituals and manifesting their presence through physical crises (with trance, cries, paroxysm of tears). Under these circumstances the body ends up being a genuine protagonist of the ritual through the upcoming participants' mental and physical crisis; furthermore, in a ritual context founded on relationships, embodiment and crisis represent the medium which drives the neo-shamanic construction.
I observed that neo-shamanic practices are intrinsically founded on vagueness and are in search of credibility, and the body with his crises becomes the point of convergence between the alleged neo-shamanic world and contingent world.