Paper short abstract:

This presentation explores help-seeking around, and conceptualisations of, mental disturbance and distress in the Acholi community of northern Uganda following the 20-year LRA conflict, and how these impact on community survival in the face of overwhelming levels of mental suffering and dysfunction.

Paper long abstract:

The Acholi community of northern Uganda has seen a massive increase in peko ma wic, 'problems of the head', over the last few years. The forms these take are in the main familiar (an exception being the recently identified 'nodding disease'), but very high incidences of the conditions known or described as cen, (possession by a vengeful spirit) and the self-descriptive 'over-thinking', and suicide, are widely associated with aspects of the twenty year Lord's Resistance Army (LRA) conflict, which ended on Ugandan soil in 2006. In particular, the experience of extended displacement and the associated loss of social capital is seen as catastrophic, even to a greater extent than war violence.

In all cultures, forms of mental disturbance and distress are often deeply frightening, disorientating and debilitating to those around. Conceptual frameworks of madness, whether moral, spiritual or medical, function to control this fear. This presentation seeks to put the observed help-seeking behaviour of Acholi people around mental disturbance and distress into the context of the conceptual frameworks available to them. There can be a temptation to conflate locally culturally defined conditions with specific psychiatric entities and categories of Western culture where there is some overlap of symptoms, but this can obscure the enormity of the difference in the underlying conceptual frameworks. In particular there is a need to consider how these frameworks are functioning at a social level in a community that at times can seem about to be overwhelmed by mental suffering and dysfunction.