Explanatory Models and Care-Seeking: A Critical Account

Abstract

This chapter is based on research not primarily devoted to utilization or care-seeking. For the past ten years, the author has been interested in the relation between meaning and illness. Carrying out field research in a small Turkish town in Iran (Good, 1977; Good and Good, 1982), consulting with psychiatrists and primary care practitioners in the management of depressed Iranian immigrants, discussing the relation of health care to their lives with members of a small community on the north coast of California, and talking with medical students and research physicians about the work of doctoring, he has been interested in how people face the “reality shock” of illness, how they make sense of the experience and revise their understanding of the world in light of that experience. From the perspective of symbolic anthropology, the primary focus of cross-cultural research is considered to be the study of the relation of human action to its sense, rather than behaviour to its determinants. “Many social scientists,” Geertz wrote in 1983 (p. 19), “have turned away from a laws and instances ideal of explanation toward a cases and interpretations one, looking less for the sort of thing that connects planets and pendulums and more for the sort that connects chrysanthemums and swords.” Medical anthropology, from this perspective, is a meaning-centered or interpretive program. Medical anthropologists attempt to understand how members of a society bring to meaning those disorders that appear as fundamental and unwelcome realities, how they construe the relationship of those realities to previous and concurrent difficulties in their lives, how illness idioms articulate the experience of disorder, and how individuals seek and engage in therapies in an effort to transform those illness realities.