面子、人情和家庭：中美精神衛生問題的社會面

Face, Favor and Families: The Social Course of Mental Health Problems in Chinese and American Societies

由於受到西方文化觀念的長期主導，幾乎所有的精神衛生工作者都過分注重對精神問題的一種被誇大的個人主義和深層內省的心理學探索，而很少關心患者的人際關係過程。在中國和北美有關精神衛生問題及患者的求助行為的研究顯示，精神分裂症、憂鬱症和身體化的發生原因、表現形式及最終結果都受到人際關係過程的影響。本文中，作者用自己和同僚的研究來論述這個觀點，並特別指出，中國傳統文化脈絡及某些特定社會環境中的“面子”、“人情”在反應家庭、工作及其它社會關係對患者的疾病體驗、病程及治療的影響時，具有更為深刻的含意。由于中國傳統文化中將它與“痛苦”、“應付”一樣解釋為“社會的”過程，故作者建議我們可以據此設計更新的、準確而實用的精神病理學和治療方法，制定更為全面的精神衛生政策及研究計劃。

The position advanced in this paper is that, owing to Western cultural preoccupations which have long dominated the field, mental health professionals globally have overly concentrated on an exaggerated individualistic, intrapsychic orientation to mental health problems that restricts attention away from interpersonal processes. The study of mental health problems and coping practices in Chinese and North American cultures clarifies the contribution of these interpersonal processes to the origins, forms and consequences of such mental health problems as schizophrenia, depression and somatization. The authors draw upon their own research and that of others to illustrate this point. They also advance a special view of the social context of these conditions that draws upon indigenous Chinese categories, such as ''face'' and ''favor'', to obtain a deeper appreciation of the means through which familial, work and other social institutional relationships in local worlds mediate the experience of illness including its course and treatment. The authors suggest that this perspective, based as it is on indigenous Chinese interpretations of experiences such as suffering and coping as social processes, offers a useful corrective to the models of psychopathology and treatment that dominate the mental health field, an alternative perspective that can be applied in mental health policies and programs globally.