Narrative strategies in medical discourse: constructing the psychiatric "case" in a non-western setting

The organizing goal of the present study was to analyze and understand the "discursive presentation" of the Egyptian psychiatric patient through the texts, or narratives, contained within the patient medical charts. It is argued that the medical record, as a written document blending overt medical imperatives with more unexamined cultural assumptions about self-hood and abnormality, is an unusually rich source of discursive data concerning the "cultural negotiations" implicit in the construction of the patient according to the two (often competing) worldviews represented by western biomedicine and traditional Egyptian culture. Psychiatry in Egypt is much more than a "foreign transplant"; to assume this is to deny the culturally constructed nature of western biomedicine and psychiatry, which have their roots in historical and cultural notions of self, society, the individual, and normality versus abnormality (Transcultural Psychiat. 35(3) (1998) 352). Egyptian psychiatry is the product of an ongoing active blending of two very different conceptualizations of these issues.