Iranian Rehabilitation Journal (Mar 2024)

Cultural Placebos From the Wild in Patients With Mental Disorders: The Case of the Nour Association in Fez-Morocco

  • Hicham Khabbache,
  • Khalid Ouazizi,
  • Driss Ait Ali,
  • Abdelhalim Cherqui,
  • Amelia Rizzo,
  • Livio Tarchi,
  • Sefa Bulut,
  • Łukasz Szarpak,
  • Mohamed Makkaoui,
  • Hanane El Ghouat,
  • Parisa Jalilzadeh Afshari,
  • Rezvaneh Namazi Yousefi,
  • Francesco Chirico

Journal volume & issue
Vol. 22, no. 1
pp. 129 – 138

Abstract

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Objectives: In urgent situations, like those experienced by the Nour Association, individuals often turn to their ethnocultural backgrounds and ingrained coping mechanisms to enhance their psychological and overall well-being. Methods: This study employed a dual-analytical approach. Initially, participant observation was used to understand the day-to-day activities within the Nour Center’s authentic environment. Subsequently, three cognitive theories—conceptual metaphor, schema, and frame theory were applied to analyze and interpret the transformation in the patients’ conceptual systems comprehensively. Results: We detected that the patient community at the Nour Center utilized various socio-cultural practices (drama roleplay, peer-support therapy, and task-shifting) to create an improvised, theory-independent recovery program focused on ‘awakening’ and ‘self-empowerment’. These latter were mediated by higher-order meta-cognitive processes, such as ‘self-regulation’ and ‘self-description’, frames, such as ‘the home frame’ and ‘the hospital frame’, and schemata, such as ‘the function schema’, which are foundational to ‘cultural placebos’. Discussion: The present findings established that both general health and mental health are significantly shaped by societal influences, indicating that cultural therapy emerges from the intricate dynamics of sub-cultural social systems. Ultimately, concepts of illness and recovery are subject to cultural negotiation.

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