Keeping it together: Idioms of resilience and distress in Thai Buddhist mindlessness

Abstract

Mindfulness is increasingly lauded as a mark of well-being around the world, but less often is its opposite, mindlessness, articulated in discussions of mental health. In Thailand, where people follow the kinds of Theravāda forms of Buddhism that have inspired today's global mindfulness movement, “mindlessness” is understood as a culturally salient mark of distress. In this article I address what mindlessness looks like for people in and around the Northern Thai city of Chiang Mai, where mindlessness can be thought of as ephemeral and passing as a fleeting forgetfulness that necessitates re-reading a page in a book, or as long lasting and powerful as a destabilizing condition to be treated in the in-patient ward of a psychiatric hospital. I emphasize local meanings and contexts of mindlessness, and their entanglement with broader discourses in the mindfulness movement, in order to point to mindlessness as a type of local and potentially international idiom of distress. I do this to argue for both the continued importance of cultural concepts of distress in our psychiatric nosology, and for further study into the slippages that can occur when local idioms like mindfulness go global.

Cultural concepts of distress and psychiatric disorders: Understanding symptom experience and expression in context

“…The result is a tapestry of meanings that must be disentangled to make sense of each person's experience. The article by Cassaniti (2019) identifies how mindfulness meditation as a globalized evidence-based therapy supported by its Westerntrained practitioners is interacting with and sometimes displacing related indigenous concepts of mindfulness in Northern Thailand both as an idiom of resilience and a form of healing. The culturally distinct frames that are embedded in these constructs -such as different understandings of happiness, personhood, impermanence, memory, morality, and what constitutes the good life -often remain unexamined in clinical practice, even when they are noticed by the participants.…”

“…Recently, the attention in idioms in health research has expanded to include ''idioms of wellness'' or ''resilience,'' spurred, no doubt, by the move towards a strengths-based anthropology and therapeutics (Eggerman & Panter-Brick, 2010). This new focus is illustrated by three articles in this issue (Cassaniti, 2019;Kim, Kaiser, Bosire, Shabazian, & Mendenhall, 2019;Snodgrass, Dengah, Polzer, & Else, 2019). This kind of idiom is defined as expressions of commitments, capacities, and positive states that signal the good life and the ability to cope (Snodgrass et al, 2019).…”

“…However, the same label may be used to describe the experience of an individual with multiple psychiatric diagnoses whose ataques occur more frequently and with minor provocation (Guarnaccia, 1993). This polysemy is illustrated in the papers by Cassaniti (2019) and Mendenhall and colleagues (2019), which describe a broad range of severity for ''mindlessness'' in Northern Thailand and ''thinking too much'' in urban Kenya, respectively.…”

“…Transcultural Psychiatry 56(4) predicament, including the presence of interpersonal, social or systemic problems that may have no clear place in our current individually oriented nosology. The article by Cassaniti (2019) describes how the idiom of mindlessness in Northern Thailand can function as a doorway into stories of suffering related to marital infidelity, alcoholism, grief, family neglect, and conflict over homosexuality, among other predicaments. Through associated etiological frameworks, mindlessness can likewise lead to various potentially empowering interventions, including meditation, the use of bracelets, and engagement with supernatural powers.…”

Culture-bound syndromes, idioms of distress, and cultural concepts of distress: New directions for an old concept in psychological anthropology

“…They ultimately provide a means to resist the neoliberal reforms that are a root cause of distress among rural Mexican communities. Along with Yahalom, other authors (Cassaniti, 2019;Gibson, Haslam & Kaplan, 2019) show how idioms of distress can facilitate socially acceptable and indirect complaints -indirect in that they do not draw explicit attention to structural violence, yet they point obliquely to the drivers of distress at the heart of these complaints. Gibson and colleagues note how, in Tuvalu, concerns around climate change have become a central and explicit part of local explanations for broad forms of distress such as manavase (anxiety, worry).…”