Shame as a cultural index of illness and recovery from psychotic illness in Java

Abstract

Objective: Most studies of shame have focused on stigma as a form of social response and a socio-psychological consequence of mental illness. This study aims at exploring more complex Javanese meanings of shame in relation to psychotic illness.

Method: Six psychotic patients and their family members participated in this research. Ethnographic fieldwork was conducted in Yogyakarta, Indonesia.

Result: Thematic analysis of the data showed that participants used shame in three different ways. First, as a cultural index of illness and recovery. Family members identified their member as being ill when they had lost their sense of shame. If a patient exhibited behavior that indicated the reemergence of shame, the family saw this as an indication of recovery. Second, as an indication of relapse. Third, as a barrier toward recovery.

Conclusions: Shame is used as a cultural index of illness and recovery because it associated with the moral-behavioral control. Shame may also be regarded as a form of consciousness associated with the emergence of insight. Further study with a larger group of sample is needed to explore shame as a 'socio-cultural marker' for psychotic illness in Java.

Keywords: Javanese; Psychotic illness; Recovery; Shame.