In an age where psychiatric disorders are an increasing problem at both local and global levels, the need for qualitative ethnographic work by anthropologists is becoming more and more critical in understanding the issues surrounding diagnosis and treatment of mental health issues (Schlaepfer & Nemeroff, 2012, p. 1). By examining Estroff’s (1981) Making it Crazy, a review will be presented that analyses Estroff’s theoretical stance and how its application is both useful and a hindrance in understanding the complexities of psychiatric disorders. While Estroff incorporates interpretative anthropology, structural-functionalism, and various other anthropological, sociological, and psychological methods in her case study, her main theoretical stance that will be examined is an interpretative anthropological one. Through first providing a brief outline of Estroff’s ethnography and a definition of interpretative anthropology, the way she explores her subject through various interpretive methods will be demonstrated with an analysis of its strengths and weaknesses. By applying an interpretive framework, Estroff is able to gain an in-depth understanding of the complexities of patient life. However if other anthropological theories had been integrated into the analysis a more holistic interpretation and conclusion would have been reached.
Making it Crazy centres on the lives of deinstitutionalised patients in Madison, Wisconsin, with Estroff spending approximately two years exploring the routines of these patients. In her analysis, Estroff pays particular attention towards the Program of Assertive Community Treatment (PACT) and the way it shaped patients’ lifestyle choices and how they viewed themselves. An examination of how the label ‘crazy’ is attributed to survival at a financial, psychological, and social level are presented alongside the effect of increased prescription of newly developed anti-psychotic medicines. Finally, Estroff looks at how the trend towards deinstitutionalisation has brought about new rules for ‘making it’ in society when you are ‘crazy’. Throughout the ethnography, Estroff draws heavily on interpretative theories to both analyse and explain patient behaviours.
Interpretative anthropology is a theoretical position that emphasises the uniqueness of cultures and cultural relativism. It implies that all cultures are of equal value and each culture must be studied in relation to its own customs, traditions, and ideas, which require an objective approach and in-depth analysis particular to that culture (Geertz, 1987, p. 520-526). The aim of interpretative anthropology is to interpret the meanings, or networks of significance, in each culture and the areas within it, from the perspective of the ‘native’. For instance, a hand gesture may have different meanings depending on the context of the situation, how it is performed, and the relationships between individuals and different groups in that society (Peoples & Bailey, 2012, p. 89-90).
Interpretative anthropology states that culture is essentially a system of meanings and all social interactions are symbolic and meaningful (Samuel, 1990, p. 30-31). The main technique is to view human culture as being externalised in cultural artefacts such as ritual, myth, art, language, and social behaviour, with these reflecting social patterns, morals, and patterns of human relationships within society. One method of achieving this is to apply a ‘thick description’, which looks to explain human behaviour and its associated meanings in relation to the context it is displayed in. This can be done through reading cultural practices such as texts, games, or rituals (Leff & Kauffeld, 1989, p.45). By applying a thick description, an interpretative anthropologist can gain an understanding of the hierarchy of cultural categories within society and the meaning behind different forms of communication used in that society, whether these are verbal or nonverbal in nature (Erickson & Murphy, 2008, p. 163).