Our expert says:
Interesting question, of course. I have come across 'Amafufunyana' and 'ukuthwasa' when working in Natal, and there were in the past psych's at the University of Natal and think at Stellenbosch with a special interest in these conditions, but I think they've all retired or emigrated by now.
Although these and related "culture-bound" disorders ( appearing solely within a specific culture and dependent on the beliefs of that particular culture ) are quite common, I have never heard of a support group for helping with them, though this might indeed be an excellent idea. All cultures seem to have variations on such disorders. Even apparently trivial examples, like the widespread belief in white cultures, that you will come to harm if you sit "in a draft", though there's no actual evidence that this is a harmful practice.
Very occasionally such a condition may hop across a cultural border as it were. For instance, the Chinese have a condition called Koro, in which a man is seized by panic, and believes that his penis is shrinking into his body and that he will die when it retracts fully. So he may rush into hospital, with his parts clasped between a pair of chopsticks, trying to prevent them from retracting further.! I have seen a very similar case in a young white Englishman in London. But generally, the conditions remain "bound" within the boundaries of a particular culture.
Generally, purely cultural disorders are best handled by the traditional healers of that culture, both because such healers are confident in dealing with them, and because te patient is likely to have faith in them and expect to be helped by them.
I'm not sure what to make of the Stellenbosch research, which has several major weaknesses. The bigest of which is that they looked only at Xhosa patients who had later received a Western diagnosis of schizophrenia ( which they probably had ) and not any any Xhosa patient with either condition who had been successfully treated within his/her culture. So one cannot assume that patients with either condition HAVE schizophrenia. Within a culture where similar symptoms are usually described with one or other of these terms, schizophrenia may well get the same label, without being the same thing at all. And a patient developing schizophrenia within such a community could well have their symptoms both shaped and explained by the prevailing views of amafufunyana and/or ukuthwasa.
As schizophrenia most commonly has its onset in young adults, and I expect that your mother is somewhat older than that, don't think it's likely that schizophrenia is her problem, which could well be amafufunyana, or some other condition ( such as the confusion caused by a severe infection ) being called amafufunyana.
It's generally been thought to be useful for Western practitioners to seek to understand such cultural disorders and to be prepared to refer them to a traditional healer, and to offer training to traditional healers to recognize the more sinister signs of schizophrenia, and refer them for Western treatments which can be so useful in that case.
I hope your mother does well with proper traditional intervention --- let us know in fresh messages, how she's doing.
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