The construction of religious and cultural meaning in Egyptian psychiatric patient charts

Abstract

This paper explores the use of religious symbols and metaphors in Egyptian psychiatric inpatient charts to portray psychiatric pathology and, by extension, the role that religious symbols play in constructing psychiatric illnesses. This represents a deconstruction of patient charts, assuming that the psychiatrist chooses aspects of family and patient discourse which best represent unexamined cultural ideas of person and illness, normality and abnormality. All of the psychiatrists writing the charts were Egyptian and shared much of the same cultural background with their patients, excluding their medical training. Therefore, while chart discourse is used to justify a psychiatric diagnosis, it is also the product of a shared cultural history; a tacit agreement about what constitutes a meaningful story. This paper focuses mainly upon discourse that has religious connotations, for the reason that these seemed to be more invested with cultural meaning than other delusional themes. These religious symbols and metaphors are interpreted in light of their symbolic associations with certain existential states, the family unit and with society as a whole.

“The language of madness is not a pathology, a description of an isolated sickness, but commentary on patterns of relatedness and their interruptions, on the fantasies and defences that define the human project as an interpenetration of what Jacques Lacan (1968) calls “the Imaginary with the Real”. (Glass, 1989, p. 6).

Notes

 Medical schools in Egypt developed according to the British model following the British occupation of Egypt in the late 18th early 19th century, and they remain so today (Mayers, 1984).

 The files of patients presenting with psychosis were kept separately from those of patients suffering from major depression (in itself a rare reason for admission), drug addiction, or mental retardation.

 Although it was impossible to know the criteria upon which the earlier diagnoses were based, the most recent diagnostic system used in this particular hospital was based upon the International Classification of Disease (ICD-10).