Phenomenology and the Social Context of Psychiatry by Magnus Englander

Author:Magnus Englander
Language: eng
Format: epub
Publisher: Bloomsbury UK

Autism in India: The introduction of ‘Western’ approaches in a ‘non-Western’ culture

Desai (2012) was interested in cultural issues vis-à-vis clinical psychology, specifically how people in various cultures experience, understand, and handle what would be diagnosed as a behavioral or mental health problem in North America and Europe (and increasingly elsewhere). This topic is of increasing interest due to ongoing globalization and intercultural exchange, which calls for clinical psychology and related behavioral health fields to more fully develop knowledge of diverse cultures and local communities to inform practice and policy. Desai worked with collaborators at the Sangath Centre in India as part of a larger project, funded by Autism Speaks (Grant No. 5621) that sought to better understand the local experiences of parents whose children had been given a diagnosis of an autism spectrum disorder (ASD). He investigated how these parents understood and cared for their children over time, from anticipations before their child’s birth to the present, including their interactions with practitioners from the diverse traditions of care. In order to understand parents’ lives as embedded in their cultural contexts, researchers put aside theoretical and cultural preconceptions, soliciting and analysing descriptions based directly on parents’ ‘indigenous’ experiences.

Participants for the study were the mothers and fathers as well as one uncle and aunt of caregivers in twelve families of children diagnosed with an ASD by local professionals using DSM-based criteria (i.e., thirteen total parent sets). After being identified in urban, semi-urban, and rural schools, centres, and community groups, participants were interviewed for one to two hours, and follow-up interviews provided more in-depth exploration of parents’ experiences and more comprehensive narratives. The analysis, following Giorgi’s (1985, 2009) method, discerned the general temporal structure of parenting a child with ASD from before birth expectations through the present time (Desai et al., 2012).

One of the most important findings concerned the context of parents’ local community in the meaning of their child’s life at various developmental junctures. Parents came to struggle with the open question of whether their child would be accepted, welcomed, and have a valued place in progressively expanding social settings, usually beginning with school and culminating in the adult world of work and community. These concerns developed over four temporal phases (substructures): Phase 1: Perceiving their child as having an open future, and welcoming their child with a nurturing relationship; Phase 2: Perceiving their child’s unexpected social disruptions as temporary within familiar settings, and seeking advice when the situation is unmanageable; Phase 3: Unfavorably comparing their child’s performances to those of other children in pivotal community settings and seeking help for their child to meet pedagogical goals; Phase 4: Accepting their child’s pervasively limited world-relations in the present and future while pursuing alternate adult activities and making the world more welcoming for children like their own. When parents saw that their child’s standing and future success were threatened in social settings, their attitude featured paradoxes of acceptance and change, with regard to first their child and then the social world. That is,

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