First, engaging in a conversation with others acts as a form of distraction that might help persons experiencing hallucinations to keep their minds focused and their attention distracted from the contents thereof. There were two processes underlying this coping strategy. Ĭhanges in social contacts included increased social contacts and engaging in social conversations. In general, changes in social contacts and manipulating the level of sensory stimulation were the two basic coping strategies identified for the “copers”. The “copers” were found to engage more often in selective listening, such as listening only to the positive voices, and were more able to ignore them, while the “non-copers” more often tried to utilize distraction techniques. The “non-copers,” on the other hand, experienced the voices as negative and aggressive.
They could experience the voices as positive and could experience fewer comments from them. The “copers” could manage well and feel themselves to be stronger than the auditory hallucinations. Īlthough individuals with schizophrenia were often thought to be passive victims of auditory hallucinations, researches have identified the difference between the coping strategies of the “copers” and the “non-copers”. Mental illness was regarded as a punishment for violating the Confucian norms governing interpersonal relations, especially filial piety, and ancestors could become malevolent spirits to haunt their descendants who had violated Confucian teachings. Ĭonfucian thought is another traditional belief that shapes Chinese people's experience of mental health problems. Chinese people also have the folk religious belief of retribution for sin in the form of a bad spirit that would invade the body and inflict madness when misdeeds and human transgression, such as family conflict, occurred.
Chinese mental patients often attribute their problems to possession, to a charm cast on them, or to having stepped on a spirit or a “dirty thing” accidentally. In addition to traditional Chinese medicine beliefs, spirit possession and retribution for sinful deeds are other commonly held folk beliefs related to the etiology and treatment of madness by lay persons in Chinese societies, such as Hong Kong, Taiwan, and Singapore. There is not a distinct mental disorder called schizophrenia according to traditional Chinese medicine, and mental illness is broadly divided into two categories, namely, “Kuang”- psychosis with excitation and “dian”-psychosis without excitation or epilepsy. Imbalance between yin and yang and among the five elements will result in illness or psychopathology. In Chinese culture, the traditional beliefs of Chinese medicine, which emphasize the balance of yin and yang and proper proportions of five elements, including wood, fire, earth, metal, and water, have considerable influence on people's perception of health and mental health. There has been very little research on voice hearing of people with schizophrenia in different environments and cultures. However, a 15-year outcome study of 100 people with schizophrenia found that about 10% had committed suicide though about 50% had experienced improved symptomatic outcomes. There is no comprehensive study on the lifetime prevalence of schizophrenia in Hong Kong. In a study of people with schizophrenia in Beijing, China, it was found that the general lifetime prevalence of the illness was 0.49% and 0.44% for men and 0.55% for women. Schizophrenia is a group of disorders which severely disrupts the memory, visual and auditory perceptions, problem-solving, social, and cognitive abilities of the persons affected.
Schizophrenia in the Chinese Sociocultural Context
As there has been no previous study on the hearing of voices by Chinese people with schizophrenia, this paper examines their coping strategies with an emphasis on how they adopt lay practices within the sociocultural context of Hong Kong.Ģ. With the influence of traditional Chinese cultural beliefs, they may worship gods, drink “amulet tea,” or adopt methods associated with folk religions or customary lay practices in trying to copepassively or actively with the voices. In Hong Kong, while psychiatric medication is the primary treatment, there are no specialized services for Chinese patients with the problem of hearing voices. The voices, particularly those with negative and critical connotations, would directly or indirectly affect their emotional, economic, occupational, and social functioning. People in an acute episode of schizophrenia are characterized by the positive symptom of auditory hallucinations or voice hearing. Schizophrenia is a major mental illness in contemporary society which affects about 1% of the world population.
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