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Sinking heart: A Punjabi communication of distress

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  • Krause, Inga-Britt

Abstract

Within transcultural psychiatry there is a continuing debate between universalist and relativist positions. This debate focuses on the translation of Western psychiatric categories to non-Western languages and cultural contexts, and on the cross-cultural applicability of a Western model of human nature. This debate is of concern to medical practitioners and other primary carers who work with ethnic minority patients. The paper describes a syndrome of heart distress referred to as 'sinking heart' by Punjabis living in Bedford, and it discusses how far this condition correlates with Western psychiatric categories. 'Sinking heart' is an illness in which physical sensations in the heart or in the chest are experienced and these symptoms are thought to be caused by excessive heat, exhaustion, worry and/or social failure. The Punjabi model of 'sinking heart' offers a culture-bound explanation of somatic symptoms. It is based on culturally specific ideas about the person, the self and the heart and on the assumption that physical, emotional and social symptoms of pathology accompany each other. This model is compared with Western notions of depressions and with medical models of heart distress, type A behaviour pattern and stress. The paper concludes that the Punjabi model of sinking heart does not exactly correspond to any of these. The sinking heart model bears closest resemblance to a Western model of stress. The similarity between these two models is in the form rather than in the content.

Suggested Citation

  • Krause, Inga-Britt, 1989. "Sinking heart: A Punjabi communication of distress," Social Science & Medicine, Elsevier, vol. 29(4), pages 563-575, January.
    • Handle: RePEc:eee:socmed:v:29:y:1989:i:4:p:563-575
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    Cited by:

    1. Ruma Bose, 1997. "Psychiatry and the Popular Conception of Possession Among the Bangladeshis in London," International Journal of Social Psychiatry, , vol. 43(1), pages 1-15, March.
    2. Tine Van Bortel & Steven Martin & Sabrina Anjara & Laura B Nellums, 2019. "Perceived stressors and coping mechanisms of female migrant domestic workers in Singapore," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-15, March.
    3. Kamaldeep Bhui & Yvonne Christie & Dinesh Bhugra, 1995. "The Essential Elements of Culturally Sensitive Psychiatric Services," International Journal of Social Psychiatry, , vol. 41(4), pages 242-256, December.
    4. Kamaldeep Bhui & Peter Herriot & Simon Dein & J.P. Watson, 1994. "Asians Presenting To a Sex and Marital Therapy Clinic," International Journal of Social Psychiatry, , vol. 40(3), pages 194-204, September.
    5. Kamaldeep Bhui & Geraldine Strathdee & Reshad Sufraz, 1993. "Asian Inpatients in a District Psychiatric Unit: an Examination of Presenting Features and Routes Into Care," International Journal of Social Psychiatry, , vol. 39(3), pages 208-220, September.
    6. Keith Lloyd, 1993. "Depression and Anxiety Among Afro-Caribbean General Practice Attenders in Britain," International Journal of Social Psychiatry, , vol. 39(1), pages 1-9, March.
    7. Aradhana S. Anand & Raymond Cochrane, 2005. "The Mental Health Status of South Asian Women in Britain," Psychology and Developing Societies, , vol. 17(2), pages 195-214, September.
    8. Sushrut Jadhav, 1996. "The Cultural Origins Western Depression," International Journal of Social Psychiatry, , vol. 42(4), pages 269-286, December.
    9. Dinesh Bhugra, 1997. "Setting Up Psychiatric Services: Cross-Cultural Issues in Planning and Delivery," International Journal of Social Psychiatry, , vol. 43(1), pages 16-28, March.
    10. Ravinder Barn, 2008. "Ethnicity, Gender and Mental Health: Social Worker Perspectives," International Journal of Social Psychiatry, , vol. 54(1), pages 69-82, January.

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    Keywords

    Punjabi heart depression stress;

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