Advertisement

Understanding Culture, Resilience, and Mental Health: The Production of Hope

  • Catherine Panter-Brick
  • Mark Eggerman
Chapter

Abstract

The authors report on their multidisciplinary and longitudinal studies of Afghan families that included paired interviews with adolescents and adult caregivers. The authors argue that cultural values are the “bedrock” of resilience: they underpin the meaning attributed to great suffering, hope for the future, and a sense of emotional, social, and moral order to ordinary and extraordinary aspects of life. Remarkably, they show that war-related trauma is not the principal driver of poor mental health: traumatic experiences are linked to fractured family relationships and a failure to achieve personal, social, and cultural milestones. Resilience, meanwhile, rests upon a demonstration of family unity. In the context of structural disadvantage that includes poverty, crowded living conditions, and exposure to violence, the authors also show that cultural dictates come to entrap Afghans in the pursuit of honor and respectability, a core facet of psychosocial resilience. The chapter highlights linkages between psychosocial and structural resilience, cautioning against a simplistic view of culture as a set of protective resources. The authors discuss the ramifications of social policies that raise not just hope, but undue expectations without sufficient resource provision.

Keywords

Mental Health Child Mental Health Political Violence Resource Provision Social Ecology 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Almedom, A. M., Evelyn, A. B., & Adam, G. M. (2010). Identifying the resilience factor: An emerging counter narrative to the traditional discourse of “vulnerability” on “social suffering”. In H. Bradbey & G. H. Hundt (Eds.), Global perspectives on war, gender and health: The ­sociology and anthropology of suffering (pp. 127–145). England: Ashgate.Google Scholar
  2. Almedom, A. M., & Glandon, D. (2007). Resilience is not the absence of PTSD any more than health is the absence of disease. Journal of Loss & Trauma, 12(2), 127–143.CrossRefGoogle Scholar
  3. Bakhshi, P., & Trani, J. (2006). Towards inclusion and equality in education? From assumptions to facts. National disability survey in Afghanistan 2005. Lyon: Handicap International.Google Scholar
  4. Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge: Harvard University Press.Google Scholar
  5. Dressler, W. (2005). What’s cultural about biocultural research? Ethos, 33(1), 20–45.CrossRefGoogle Scholar
  6. Dressler, W., Balieiro, M., Ribeiro, R., & Dos Santos, J. (2007). Cultural consonance and psychological distress: Examining the associations in multiple cultural domains. Culture, Medicine and Psychiatry, 31, 195–224.CrossRefGoogle Scholar
  7. Dupree, N. H. (2004). The family during crisis in Afghanistan. Journal of Comparative Family Studies, 35, 311–331.Google Scholar
  8. Eggerman, M., & Panter-Brick, C. (2010a). Fieldwork as research process and community engagement. In J. McClancy & A. Fuentes (Eds.), Fieldwork: Examin-ing its practice (pp. 137–155). Oxford: Berghahn.Google Scholar
  9. Eggerman, M., & Panter-Brick, C. (2010b). Suffering, hope, and entrapment: Resilience and cultural values in Afghanistan. Social Science & Medicine, 71, 71–83.CrossRefGoogle Scholar
  10. Feldman, R., & Masalha, S. (2007). The role of culture in moderating the links between early ecological risk and young children’s adaptation. Development and Psychopathology, 19, 1–21.Google Scholar
  11. Hage, G. (2003). Against paranoid nationalism: Searching for hope in a shrinking society. London: Pluto Press.Google Scholar
  12. Hobfoll, S., Watson, P., Bell, C., Byrant, R., Brymer, M., Friedman, M., et al. (2007). Five essential elements of immediate and mid-term mass trauma intervention: Empirical evidence. Psychiatry, 70(4), 283–315.Google Scholar
  13. Hobfoll, S. E., & Lilly, R. S. (1993). Resource conversation as a strategy for community psychology. Journal of Community Psychology, 21, 128–148.CrossRefGoogle Scholar
  14. Hobfoll, S. E., Palmieri, P. A., Johnson, R. J., Canetti-Nisim, D., Hall, B. J., & Galea, S. (2009). Trajectories of resilience, resistance, and distress during ongoing terrorism: The case of Jews and Arabs in Israel. Journal of Consulting Clinical Psychology, 77(1), 138–148.CrossRefGoogle Scholar
  15. Inter-Agency Standing Committee. (2007). Guidelines on mental health and psychosocial support in emergency settings. Geneva: Inter-Agency Standing Committee.Google Scholar
  16. Jordans, M., Tol, W., Komproe, I., Susanty, D., Vallipuram, A., Ntamatumba, P., et al. (2010). Development of a multi-layered psychosocial care system for children in areas of political violence. International Journal of Mental Health Systems, 4(15), 1–12.Google Scholar
  17. Kleinman, A. (2006). What really matters: Living a moral life amidst uncertainty and danger. Oxford: Oxford University Press.Google Scholar
  18. Layne, C., Waren, J., Watson, P., & Shalev, A. (2007). Risk, vulnerability. resistance, and resilience: Towards an integrative conceptualization of posttraumatic adaptation. In M. Friedman, T. Keane, & P. Resick (Eds.), Handbook of PTSD (pp. 497–520). London: Guilford Press.Google Scholar
  19. Luthar, S., Cicchetti, D., & Becker, B. (2000). The construct of resilience: A critical evaluation and guidelines for future work. Child Development, 71(3), 543–562.CrossRefGoogle Scholar
  20. Luthar, S. S., & Brown, P. J. (2007). Maximizing resilience through diverse levels of inquiry: Prevailing paradigms, possibilities, and priorities for the future. Development and Psychopathology, 19, 931–955.CrossRefGoogle Scholar
  21. Miller, K. E., & Rasmussen, A. (2010). War exposure, daily stressors, and mental health in conflict and post-conflict settings: Bridging the divide between trauma-focused and psychosocial frameworks. Social Science & Medicine, 70(1), 7–16.CrossRefGoogle Scholar
  22. Oxfam. (2006). Free, quality education for every Afghan child. Oxford: Oxfam International. Retrieved 1 August 2011, from www.unicef.org.
  23. Panter-Brick, C., Eggerman, M., Mojadidi, A., & McDade, T. (2008). Social stressors, mental health, and physiological stress in an urban elite of young Afghans in Kabul. American Journal of Human Biology, 20, 327–641.CrossRefGoogle Scholar
  24. Panter-Brick, C., Eggerman, M., Gonzalez, V., & Saftar, S. (2009). Violence, suffering, and mental health in Afghanistan: A school-based survey. The Lancet, 374, 807–886.CrossRefGoogle Scholar
  25. Panter-Brick, C., & Fuentes, A. (2010). Health, risk, and adversity. In C. Panter-Brick & A. Fuentes (Eds.), Health, risk, and adversity. New York: Berghahn Books.Google Scholar
  26. Panter-Brick, C., Goodman, A., Tol, W., & Eggerman, M. (2011). Mental health and childhood adversities: A longitudinal study in Kabul, Afghanistan. Journal of the American Academy of Child & Adolescent Psychiatry, 50(4), 349–363.CrossRefGoogle Scholar
  27. Reed, R., Fazel, M., Jones, L., Panter-Brick, C., & Stein, A. (2011). The mental health of refugee and internally displaced children. Part I: A systematic review of risk and protective factors in low and middle-income countries. The Lancet. Published online August 10, 2011.Google Scholar
  28. Rutter, M. (2011). Resilience: Causal pathways and social ecology. In M. Ungar (Ed.), The social ecology of resilience: A Handbook of Theory and Practice. New York: Springer.Google Scholar
  29. Tol, W., Jordans, M., Kohrt, B., Betancourt, T., & Komproe, I. (in press). Promoting mental health and psychological wellbeing in children affected by political violence: Current evidence for an ecological resilience approach. In C. Fernando & M. Ferrari (Eds.), Children and war: A handbook for promoting resilience. New York: Springer.Google Scholar
  30. Tol, W. A., Komproe, I. H., Jordans, M. J., Gross, A. L., Susanty, D., Macy, R. D., et al. (2010). Mediators and moderators of a psychosocial intervention for children affected by political violence. Journal of Consulting and Clinical Psychology, 78(6), 818–828.CrossRefGoogle Scholar
  31. Tol, W. A., Komproe, I. H., Susanty, D., Jordans, M., Macy, R., & De Jong, J. (2008). School-based mental health intervention for children affected by political violence in Indonesia: A randomized cluster trial. Journal of the American Medical Association, 300, 655–662.CrossRefGoogle Scholar
  32. Trani, J.-F., Bakhshi, P., Noor, A. A., Lopez, D., & Mashkoor, A. (2010). Poverty, vulnerability, and provision of healthcare in Afghanistan. Social Science & Medicine, 70(11), 1745–1755.CrossRefGoogle Scholar
  33. Turton, D., & Marsden, P. (2002). Taking refugees for a ride? The politics of refugee return to Afghanistan. In Afghanistan Research and Evaluation Unit (AREU), Issue paper series. Kabul, Afghanistan.Google Scholar
  34. Ungar, M. (2008). Resilience across cultures. British Journal of Social Work, 38, 218–235.CrossRefGoogle Scholar
  35. Ungar, M. (2011a). The social ecology of resilience: Addressing contextual and cultural ambiguity of a nascent construct. American Journal of Orthopsy­chiatry, 81, 1–17.CrossRefGoogle Scholar
  36. Ungar, M. (2011b). Introduction. In M. Ungar (Ed.), The social ecology of resilience: Culture, context, resources and meaning. New York: Springer.Google Scholar
  37. van Ommeren, M. (2003). Validity issues in transcultural epidemiology. British Journal of Psychiatry, 182, 376–378.CrossRefGoogle Scholar
  38. Weiss, M., Saraceno, B., Saxena, S., & Van Ommeren, M. (2003). Mental health in the aftermath of disasters: Consensus and controversy. Journal of Nervous and Mental Disease, 191(9), 611–615.CrossRefGoogle Scholar
  39. World Health Organization (WHO) (2008). Social determinants of health in countries in conflict: A perspective from the Eastern Mediterranean region. Cairo, Egypt: World Health Organization Regional Office for the Eastern Mediterranean.Google Scholar
  40. Worthman, C. M. (in press). Inside/out and outside/in global developmental theory, policy, and youth. Ethos.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Anthropology and Jackson Institute for Global AffairsYale UniversityNew HavenUSA
  2. 2.Macmillan Center for International and Area StudiesYale UniversityNew HavenUSA

Personalised recommendations